Department of Cardiology, Sorlandet Hospital, Postboks 416 Lundsiden, 4604 Arendal, Norway.
Department of Cardiology, Oslo University Hospital Ullevaal, Oslo, Norway.
Europace. 2023 May 19;25(5). doi: 10.1093/europace/euad075.
Atrial fibrillation (AF) is the most common arrhythmia worldwide. The AF is associated with severe mortality, morbidity, and healthcare costs, and guidelines recommend screening people at risk. However, screening methods and organization still need to be clarified. The current study aimed to assess the feasibility of a fully digital self-screening procedure and to assess the prevalence of undetected AF using a continuous patch electrocardiogram (ECG) monitoring system.
Individuals ≥65 years old with at least one additional risk factor for stroke from the general population of Norway were invited to a fully digital continuous self-screening for AF using a patch ECG device (ECG247 Smart Heart Sensor). Participants self-reported clinical characteristics and usability online, and all participants received digital feedback of their results. A total of 2118 individuals with a mean CHA2DS2-VASc risk score of 2.6 (0.9) were enrolled in the study [74% women; mean age 70.1 years (4.2)]. Of these, 1849 (87.3%) participants completed the ECG self-screening test, while 215 (10.2%) did not try to start the test and 54 (2.5%) failed to start the test. The system usability score was 84.5. The mean ECG monitoring time was 153 h (87). Atrial fibrillation was detected in 41 (2.2%) individuals.
This fully digitalized self-screening procedure for AF demonstrated excellent feasibility. The number needed to screen was 45 to detect one unrecognized case of AF in subjects at risk for stroke. Randomized studies with long-term follow-up are needed to assess whether self-screening for AF can reduce the incidence of AF-related complications.
NCT04700865.
心房颤动（AF）是全球最常见的心律失常。AF 与严重的死亡率、发病率和医疗保健成本相关，指南建议对高危人群进行筛查。然而，筛查方法和组织仍需明确。本研究旨在评估完全数字化自我筛查程序的可行性，并使用连续贴片心电图（ECG）监测系统评估未检测到的 AF 的患病率。
从挪威普通人群中邀请年龄≥65 岁且至少有一个中风额外危险因素的个体进行完全数字化的连续自我筛查 AF，使用贴片 ECG 设备（ECG247 Smart Heart Sensor）。参与者在线自我报告临床特征和可用性，所有参与者都收到了他们结果的数字反馈。共有 2118 名平均 CHA2DS2-VASc 风险评分为 2.6（0.9）的个体参加了该研究[74%为女性；平均年龄 70.1 岁（4.2）]。其中，1849 名（87.3%）参与者完成了 ECG 自我筛查测试，215 名（10.2%）未尝试开始测试，54 名（2.5%）未能开始测试。系统可用性评分为 84.5。平均 ECG 监测时间为 153 小时（87）。在 41 名（2.2%）个体中检测到 AF。
这种完全数字化的 AF 自我筛查程序具有极好的可行性。需要筛查的人数为 45，以在有中风风险的受试者中发现一例未被识别的 AF 病例。需要进行随机研究并进行长期随访，以评估 AF 的自我筛查是否可以降低 AF 相关并发症的发生率。
NCT04700865。
