AUTOMATED ATRIAL FIBRILLATION DETECTION DURING ROUTINE BLOOD PRESSURE MEASUREMENT: DIAGNOSTIC ACCURACY OF THE OSCILLOMETRIC BLOOD PRESSURE MONITOR MICROLIFE BP B3 AFIB ADVANCED

Abstract

Objective: To evaluate the diagnostic accuracy of the oscillometric upper-arm cuff home blood pressure (BP) monitor Microlife BP B3 AFIB Advanced in detecting atrial fibrillation (AF) during automated BP measurement. Design and method: Participants with permanent AF aged >60 years (AF group) and others with sinus rhythm (SR) matched for age and sex (control group) were recruited. Electrocardiography (ECG) recording and blood pressure (BP) measurements were simultaneously conducted twice for each participant. Using an AF specific diagnostic algorithm of the BP monitor, the rhythmicity of heart rate was evaluated three times during each automated BP measurement. When AF is detected in at least 2 of the 3 assessments, the device reports the presence of AF detection. A single wide-range cuff of the test device was used for arm circumference 22-42 cm. Results: A total of 108 individuals were analyzed, (50%/50% with AF/SR, 59%/59% men, mean age [SD] 76±10.5/73±9.5 years for AF/SR, systolic BP 123.4±19.6/131.5±17.9 mmHg [p<0.01], diastolic BP 74.2±11.7/73.4±10.6 mmHg [p=NS]). False negative and false positive AF detection in AF and control group respectively are shown in Table. The sensitivity of the test device in detecting AF was 87%, specificity 100%, positive predictive value 100% and negative predictive value 88.5%. Conclusions: These findings indicate that the Microlife BP B3 AFIB Advanced automated BP monitor equipped with an AF detecting algorithm with triplicate assessment of the cardiac rhythm during each automated BP measurement, has an exceptional diagnostic accuracy. Thus, this novel technology can be employed as a reliable screening tool for detecting asymptomatic AF in elderly adults during routine screening or long-term monitoring of treated hypertension.