World-Class Research Center 'Digital biodesign and personalized healthcare' I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, RU.
The state budgetary institution of health care of the Moscow region 'Mytishchi city clinical hospital', Mytishchi, RU.
Glob Heart. 2022 Jan 18;17(1):4. doi: 10.5334/gh.1057. eCollection 2022.
Screening for atrial fibrillation has the potential to significantly reduce cardiovascular morbidity and mortality. However, questions in regard to how to screen, on whom to screen, and the optimal setting of screening remain unanswered.
To assess the applicability of a federal cardiac monitoring for atrial fibrillation (AF) screening and remote heart rhythm monitoring in patients at high cardiovascular risk in a mixed urban and rural population in Russia.
This is a prospective multicenter cohort study including 3249 individuals with high cardiovascular risk (mean age 56 ± 12.8 years) from the larger Moscow region who were screened for AF using a smartphone-case based single-lead ECG monitor over a period of 18 month. The endpoints were considered as number of newly diagnosed AF; mean time to diagnosis; number of patients for the first time assigned to anticoagulation therapy; frequency of adverse events.
A trial fibrillation was diagnosed in 126 patients, 36 of them for the first time. The mean time to diagnosis was 3 ± 2 days. Of 36 patients, the CHA2DS2-VASc score was ≥1 in 34 cases, ≥2 in 29 cases. Anticoagulant therapy was first induced in 31 patients. One death in newly diagnosed group and two deaths in chronic group were registered. There were a total of eight hospitalizations: one in newly diagnosed and seven in chronic AF patients.
Our results indicate that a Federal AF screening system in patients at high cardiovascular risk by using a smartphone-case based single lead ECG which is supported by centrally located ECG specialist and central data management is feasible and reliable when performed in a mixed urban and rural area. Further studies are needed to evaluate the full potential of this approach.
心房颤动（房颤）筛查有可能显著降低心血管发病率和死亡率。然而，如何筛查、筛查对象以及筛查的最佳环境等问题仍未得到解答。
评估在俄罗斯一个城乡混合人群中，使用联邦心脏监测仪进行房颤（AF）筛查和远程心律监测在心血管高危患者中的适用性。
这是一项前瞻性多中心队列研究，纳入了来自莫斯科地区的 3249 名心血管高危患者（平均年龄 56 ± 12.8 岁），使用智能手机盒单导联心电图监测仪进行了为期 18 个月的房颤筛查。研究终点包括新发房颤的数量、平均诊断时间、首次接受抗凝治疗的患者数量、不良事件的发生频率。
在 126 例患者中诊断出房颤，其中 36 例为首次诊断。平均诊断时间为 3 ± 2 天。在 36 例患者中，CHA2DS2-VASc 评分≥1 的有 34 例，≥2 的有 29 例。首次诱导抗凝治疗的有 31 例。在新诊断组中有 1 例死亡，在慢性组中有 2 例死亡。共发生 8 例住院：新诊断组 1 例，慢性 AF 患者 7 例。
我们的研究结果表明，在城乡混合地区，使用基于智能手机盒的单导联心电图的联邦房颤筛查系统，由中央心电专家和中央数据管理支持，对心血管高危患者进行房颤筛查是可行和可靠的。需要进一步的研究来评估这种方法的全部潜力。
