Home monitoring with a modified automatic sphygmomanometer to detect recurrent atrial fibrillation

J Stroke Cerebrovasc Dis. Jan-Feb 2007;16(1):8-13. doi: 10.1016/j.jstrokecerebrovasdis.2006.07.004.

Abstract

Objectives: Detecting asymptomatic atrial fibrillation would help identify patients who would benefit from anticoagulation. This study examined the application of a modified blood pressure monitor to screen for episodes of atrial fibrillation.

Methods: A modified sphygmomanometer was designed to detect atrial fibrillation. The device has a sensitivity near 100% and a specificity of up to 91%. Therefore, this device can be expected to detect all episodes of atrial fibrillation. However, the lower specificity may result in false-positive readings that could prompt unnecessary clinic visits for electrocardiogram confirmation of the rhythm. Outpatients in sinus rhythm with a history of atrial fibrillation were given the device to monitor their pulse regularity once daily to detect atrial fibrillation. Patients with irregular readings were evaluated with an electrocardiogram.

Results: Nineteen patients were monitored at home for a period ranging from 5 days to 5 months. Seven patients had recurrent atrial fibrillation identified by the monitor. Nine patients had no irregular readings for a mean of 82 +/- 40 days. Of 19 patients, 3 had false-positive irregular readings that were a result of sinus arrhythmia or ectopy.

Conclusions: The device had an acceptably low false-positive rate allowing 16 of 19 patients to use it at home for long-term atrial fibrillation monitoring. This device may help prevent strokes by identifying patients with prolonged episodes of asymptomatic atrial fibrillation who are candidates for anticoagulation.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anticoagulants / therapeutic use
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / diagnosis*
  • Atrial Fibrillation / drug therapy
  • Atrial Flutter / diagnosis
  • Electrocardiography
  • Equipment Design
  • False Positive Reactions
  • Female
  • Humans
  • Intracranial Embolism / etiology
  • Intracranial Embolism / prevention & control
  • Male
  • Pulse / instrumentation*
  • Pulse / methods
  • Recurrence
  • Self Care / instrumentation*
  • Sensitivity and Specificity
  • Sphygmomanometers*

Substances

  • Anticoagulants