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Assessment of a new algorithm to detect atrial fibrillation in home blood pressure monitoring device among healthy adults and patients with atrial fibrillation.

ABSTRACT: The authors evaluated the diagnostic accuracy of a new algorithm for detecting atrial fibrillation (AF) using a home blood pressure (BP) monitor. Three serial BP values were measured in 205 subjects with sinus rhythm and 75 subjects with AF confirmed by electrocardiogram. Irregular pulse peak (IPP) 15 was defined as follows: |interval of pulse peak - the average of the interval of the pulse peak| ≥ the average of the interval of the pulse peak × 15%. Irregular heartbeat (IHB) was defined as follows: beats of IPP ≥ total pulse × 20%. The sensitivities of IPP15 for diagnosing AF defined as two or three IHBs of three readings were 1.0 and 0.99, and the corresponding specificities were 0.97 and 0.99, respectively. The algorithm using two or more IHBs of three readings in the setting of IPP15 had the highest diagnostic accuracy for AF.

SUBMITTER: Watanabe T

PROVIDER: S-EPMC8678736 | biostudies-literature | 2021 May

REPOSITORIES: biostudies-literature

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Assessment of a new algorithm to detect atrial fibrillation in home blood pressure monitoring device among healthy adults and patients with atrial fibrillation.

Watanabe Tomonori T Tomitani Naoko N Yasui Nobuhiko N Kabutoya Tomoyuki T Hoshide Satoshi S Kario Kazuomi K

Journal of clinical hypertension (Greenwich, Conn.) 20210201 5

The authors evaluated the diagnostic accuracy of a new algorithm for detecting atrial fibrillation (AF) using a home blood pressure (BP) monitor. Three serial BP values were measured in 205 subjects with sinus rhythm and 75 subjects with AF confirmed by electrocardiogram. Irregular pulse peak (IPP) 15 was defined as follows: |interval of pulse peak - the average of the interval of the pulse peak| ≥ the average of the interval of the pulse peak × 15%. Irregular heartbeat (IHB) was defined as foll ...[more]

PMID: 33523592

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Project description:ObjectiveTo evaluate the diagnostic performance of a UK National Institute for Health and Care Excellence-recommended automatic oscillometric blood pressure (BP) measurement device incorporated with an atrial fibrillation (AF) detection algorithm (Microlife WatchBP Home A) for real-world AF screening in a primary healthcare setting.SettingPrimary healthcare setting in Hong Kong.InterventionsThis was a prospective AF screening study carried out between 1 September 2014 and 14 January 2015. The Microlife device was evaluated for AF detection and compared with a reference standard of lead-I ECG.Primary outcome measuresDiagnostic performance of Microlife for AF detection.Results5969 patients (mean age: 67.2±11.0 years; 53.9% female) were recruited. The mean CHA2DS2-VASc ( C : congestive heart failure [1 point]; H : hypertension [1 point]; A2 : age 65-74 years [1 point] and age ≥75 years [2 points]; D : diabetes mellitus [1 point]; S : prior stroke or transient ischemic attack [2 points]; VA : vascular disease [1 point]; and Sc : sex category [female] [1 point])score was 2.8±1.3. AF was diagnosed in 72 patients (1.21%) and confirmed by a 12-lead ECG. The Microlife device correctly identified AF in 58 patients and produced 79 false-positives. The corresponding sensitivity and specificity for AF detection were 80.6% (95% CI 69.5 to 88.9) and 98.7% (95% CI 98.3 to 98.9), respectively. Among patients with a false-positive by the Microlife device, 30.4% had sinus rhythm, 35.4% had sinus arrhythmia and 29.1% exhibited premature atrial complexes. With the low prevalence of AF in this population, the positive and negative predictive values of Microlife device for AF detection were 42.4% (95% CI 34.0 to 51.2) and 99.8% (95% CI 99.6 to 99.9), respectively. The overall diagnostic performance of Microlife device to detect AF as determined by area under the curves was 0.90 (95% CI 0.89 to 0.90).ConclusionsIn the primary care setting, Microlife WatchBP Home was an effective means to screen for AF, with a reasonable sensitivity of 80.6% and a high negative predictive value of 99.8%, in addition to its routine function of BP measurement. In a younger patient population aged <65 years with a lower prevalence of AF, Microlife WatchBP Home A demonstrated a similar diagnostic accuracy.

Dataset Information

Assessment of a new algorithm to detect atrial fibrillation in home blood pressure monitoring device among healthy adults and patients with atrial fibrillation.

Publications

Assessment of a new algorithm to detect atrial fibrillation in home blood pressure monitoring device among healthy adults and patients with atrial fibrillation.

Similar Datasets

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