Department of Medicine and Surgery, University of Perugia, Perugia, Italy.
Unit of Internal Medicine, Terni University Hospital, Terni, Italy.
Intern Emerg Med. 2021 Sep;16(6):1605-1611. doi: 10.1007/s11739-021-02691-2. Epub 2021 Mar 20.
Atrial fibrillation (AF), the commonest sustained cardiac arrhythmia affecting the adult population, is often casually discovered among hospitalized people. AF onset is indeed triggered by several clinical conditions such as acute inflammatory states, infections, and electrolyte disturbance, frequently occurring during the hospitalization. We aimed to evaluate whether systematic AF screening, performed through an automated oscillometric blood pressure (BP) device (Microlife WatchBP Office AFIB, Microlife AG, Switzerland), is effective for detecting AF episodes in subjects admitted to an Internal Medicine ward. 163 patients consecutively hospitalized at the Unit of Internal Medicine of the "Santa Maria" Terni University Hospital between November 2019 and January 2020 (mean age ± standard deviation: 77 ± 14 years, men proportion: 40%) were examined. Simultaneously with BP measurement and AF screening, a standard 12-lead electrocardiogram (ECG) was performed in all subjects. AF was diagnosed by ECG in 29 patients (18%). AF screening showed overall 86% sensitivity and 96% specificity. False negatives (n = 4) had RR-interval coefficient of variation lower than true positives (n = 25, p < 0.01), suggesting a regular ventricular rhythm during AF. The repeated evaluation substantially confirmed the same level of agreement. AF screening was positive in all patients with new-onset AF (n = 6, 100%). Systematic AF screening in patients admitted to Internal Medicine wards, performed using the Microlife WatchBP Office AFIB, is feasible and effective. The opportunity to implement such technology in daily routine clinical practice to prevent undiagnosed AF episodes in hospitalized patients should be the subject of further research.
心房颤动(AF)是影响成年人群体的最常见持续性心律失常,通常在住院人群中偶然发现。AF 的发作确实是由急性炎症状态、感染和电解质紊乱等几种临床情况引发的,这些情况在住院期间经常发生。我们旨在评估通过自动化示波血压(BP)设备(瑞士 Microlife WatchBP Office AFIB)进行系统的 AF 筛查是否能有效检测入住内科病房的患者的 AF 发作。163 例连续入住特伦托圣玛丽亚大学医院内科病房的患者(平均年龄±标准差:77±14 岁,男性比例:40%)于 2019 年 11 月至 2020 年 1 月期间接受了检查。在对所有患者进行 BP 测量和 AF 筛查的同时,还进行了标准的 12 导联心电图(ECG)检查。29 例(18%)患者通过 ECG 诊断为 AF。AF 筛查的总体敏感性为 86%,特异性为 96%。4 例假阴性(RR 间期变异系数低于 25 例真阳性患者(p<0.01),提示 AF 期间存在规则的心室节律。重复评估基本证实了相同的一致性水平。所有新发 AF 患者(n=6,100%)的 AF 筛查均为阳性。使用 Microlife WatchBP Office AFIB 在入住内科病房的患者中进行系统的 AF 筛查是可行且有效的。进一步研究应探讨在日常临床实践中实施这种技术以预防住院患者未诊断的 AF 发作的机会。