Abstract
BackgroundThere are many atrial fibrillation (AF) screening devices available. Validation studies have mainly been performed in optimal settings in the young population.HypothesisWe aim to compare the yield of AF detection, compliance, and patient‐based experience in an ambulatory elderly population by using intermittent electrocardiogram (ECG) recordings and continuous event recording simultaneously.MethodsThe study participants were part of the STROKESTOP II study, a Swedish screening study for AF. All participants were 75/76 years of age, were clinically free of AF, and had N‐terminal pro b‐type natriuretic peptides levels ≥125 ng/L. AF screening was performed in parallel during a 2‐week period, using a continuous event recording device (R‐test 4; Novacor) and 30‐second intermittent recordings using a handheld ECG device (Zenicor II) four times daily. Participants were asked to fill out a questionnaire with regard to compliance and ease of use of the devices.ResultsDuring continuous event recording, 6% (n = 15/269) were diagnosed with AF and intermittent ECG detected AF in 2% (n = 5/269) of the participants (P = .002). No new cases of AF were detected using intermittent ECG monitoring only, but some episodes were detected in parallel for patients. On a graded ordinal scale of 1 to 5, with 1 reflecting “very easy to use”, continuous monitoring was graded 2 (interquartile range [IQR]: 1‐3) compared to intermittent 1 (IQR: 1‐1) (P < .001).ConclusionContinuous event recording detected three times more AF compared to intermittent ECG in an elderly ambulatory population. Compliance and user‐friendliness were rated higher for the intermittent ECG device.
Highlights
There are many atrial fibrillation (AF) screening devices available
Other significant arrhythmias were overall more commonly detected using continuous monitoring compared to intermittent recordings (Table 2)
Continuous event recording detected AF in 6% (n = 15) of the participants and intermittent ECG detected AF in 2% (n = 5) (P = .002)
Summary
There are many atrial fibrillation (AF) screening devices available. Validation studies have mainly been performed in optimal settings in the young population. Hypothesis: We aim to compare the yield of AF detection, compliance, and patientbased experience in an ambulatory elderly population by using intermittent electrocardiogram (ECG) recordings and continuous event recording simultaneously. Results: During continuous event recording, 6% (n = 15/269) were diagnosed with AF and intermittent ECG detected AF in 2% (n = 5/269) of the participants (P = .002). Conclusion: Continuous event recording detected three times more AF compared to intermittent ECG in an elderly ambulatory population. Systematic screening may be considered in individuals aged >75 years or with high risk of stroke.[10] Prolonged screening has been shown to detect six times more AF in an elderly population compared to single-time point ECG.[11]
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