Medical outpatient clinics an ideal setting for atrial fibrillation screening using a handheld single-lead ECG with automated diagnosis
Refereed conference paper presented and published in conference proceedings


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摘要Background:
Subsidised medical outpatient clinics in Hong Kong have a high volume of elderly patients and seem ideally placed for screening for atrial fibrillation(AF). We evaluated feasibility of a 30 sec handheld single-lead ECG with automated AF diagnostics (AliveCor) to screen for undiagnosed (AF) in this setting.
Methods:
Consecutive patients aged >65 years attending medical clinics underwent AF screening using the AliveCor device between Dec 2014 to Jan 2016 (NCT02409654). Repeated screening was performed for patients during different clinic visits. All ECGs were over-read by a cardiologist.
Results:
A total of 9,046 patients (mean 72.1±12.1years; 49.4% male) were screened including 973 (10.8%) who underwent repeated screening. Newly identified AF was found in 1.5% (n=121/8073) on a single screen and 1.2% (n=15/973) of patients who underwent single and multiple screening, respectively. Mean age of newly diagnosed AF patients was 79.0± 9.1years and all had CHA2DS2-VASc score ≥2. Of importance, 21.1% of newly diagnosed patients had a history of stroke and 10% were taking oral anticoagulants (OAC) for indications other than AF. Overall AF prevalence was 9.4% (850/9,046). Among patients with known AF, 73.7% were taking OAC (47.6% warfarin, 26.1% NOAC), 23% were on antiplatelet therapy and 1.6% left atrial appendage occlusion.
Conclusions:
Single time point screening with automated handheld ECG is feasible and identified a significant number of patients, at high risk of stroke including 21% who had previously experienced a stroke. Repeated screening increases diagnostic yield. This setting is ideal for detection and treatment of unknown AF.
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A total of 9,046 patients (mean 72.1±12.1years; 49.4% male) were screened, including 973 (10.8%) who underwent repeated screening. Newly identified AF was found in 1.5% (n=121/9046) on a single screen, and an additional 1.2% (n=15/973) was detected in those screened on multiple occasions.
著者Yan BP, Chan LY, Lee VWY, Freedman SB
會議名稱Congress of the European-Society-of-Cardiology (ESC)
會議開始日27.08.2016
會議完結日31.08.2016
會議地點Rome
會議國家/地區意大利
會議論文集題名European Heart Journal
出版年份2016
月份8
卷號37
期次Supplement 1
國際標準期刊號0195-668X
電子國際標準期刊號1522-9645
語言美式英語

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