Clua-Espuny Josep L, Gentille-Lorente Delicia, Hernández-Pinilla Alba, Satué-Gracia Eva Maria, Pallejà-Millán Meritxell, Martín-Luján Francisco M
Servicio de Atención Primaria Terres de l'Ebre. Institut Català de la Salut. CAP Temple, Tortosa, España.
Servicio de Cardiología, Hospital Virgen de la Cinta de Tortosa. Institut Català de la Salut, Tortosa, España.
Aten Primaria. 2025 Jan;57(1):103071. doi: 10.1016/j.aprim.2024.103071. Epub 2024 Sep 11.
To assess the association between electrocardiogram (ECG) patterns according to the MVP ECG risk score (morphology-voltage-P-wave duration) and a diagnosis of Atrial Fibrillation (AF).
Prospective observational cohort study (1/01/2023-31/12/2024). SITE: Primary care.
Randomized sample of 150 patients aged 65-85 years without prior diagnosis of AF, stroke, or current anticoagulant treatment; high risk of future AF; CHA2DS2-VASc ≥2; and ability to use the FibricheckR application (App).
At baseline, a standard ECG, MVP risk score assessment, and cardiac rhythm monitoring for 15 days using the Fibricheck App were performed. The dependent variables were the presence of P-wave patterns on the electrocardiogram according to MVP risk score and a new diagnosis of AF.
The diagnosis of AF was confirmed in 14 cases (9.3%, 95% CI 5.6-15.1), 3 men and 11 women. In 3 cases, the arrhythmia was diagnosed on the baseline ECG, and in 11 cases by Holter after being reported as possible AF by the Fibricheck App. A higher prevalence of atypical advanced interatrial block (A-AIB) (p 0.007) was detected among participants with AF, as well as the prevalence of P-wave <0.1mV. (p=0.006). All new diagnoses of AF were made at scores ≥4 in the MVP risk score.
Using scales for identifying ECG patterns in high-risk subjects in primary care can facilitate the diagnosis of unknown AF.
根据二尖瓣脱垂心电图风险评分（形态-电压-P波时限）评估心电图（ECG）模式与房颤（AF）诊断之间的关联。
前瞻性观察队列研究（2023年1月1日至2024年12月31日）。地点：基层医疗。
随机抽取150名年龄在65 - 85岁之间、既往未诊断为房颤、中风或目前未接受抗凝治疗的患者；未来发生房颤的高风险；CHA2DS2-VASc≥2；以及能够使用FibricheckR应用程序（App）。
在基线时，进行标准心电图检查、二尖瓣脱垂风险评分评估，并使用Fibricheck App进行15天的心律监测。因变量是根据二尖瓣脱垂风险评分的心电图上P波模式的存在情况以及房颤的新诊断。
确诊房颤14例（9.3%，95%可信区间5.6 - 15.1），男性3例，女性11例。3例心律失常在基线心电图时被诊断，11例在Fibricheck App报告可能为房颤后通过动态心电图诊断。在房颤参与者中检测到非典型高级房间阻滞（A - AIB）的患病率较高（p = 0.007），以及P波<0.1mV的患病率（p = 0.006）。所有房颤的新诊断均在二尖瓣脱垂风险评分≥4分时做出。
在基层医疗中使用量表识别高危受试者的心电图模式有助于诊断不明房颤。
