Atrial fibrillation detection in primary care during blood pressure measurements and using a smartphone cardiac monitor

Abstract Improved atrial fibrillation (AF) screening methods are required. We detected AF with pulse rate variability (PRV) parameters using a blood pressure device (BP+; Uscom, Sydney, Australia) and with a Kardia Mobile Cardiac Monitor (KMCM; AliveCor, Mountain View, CA). In 421 primary care patie...

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Autores principales:	John D. Sluyter, Robert Scragg, Malakai ‘Ofanoa, Ralph A. H. Stewart
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/49520a6547414117bb78e015af223095
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spelling	oai:doaj.org-article:49520a6547414117bb78e015af2230952021-12-02T19:12:25ZAtrial fibrillation detection in primary care during blood pressure measurements and using a smartphone cardiac monitor10.1038/s41598-021-97475-12045-2322https://doaj.org/article/49520a6547414117bb78e015af2230952021-09-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-97475-1https://doaj.org/toc/2045-2322Abstract Improved atrial fibrillation (AF) screening methods are required. We detected AF with pulse rate variability (PRV) parameters using a blood pressure device (BP+; Uscom, Sydney, Australia) and with a Kardia Mobile Cardiac Monitor (KMCM; AliveCor, Mountain View, CA). In 421 primary care patients (mean (range) age: 72 (31–99) years), we diagnosed AF (n = 133) from 12-lead electrocardiogram recordings, and performed PRV and KMCM measurements. PRV parameters detected AF with area under curve (AUC) values of up to 0.92. Using the mean of two sequential readings increased AUC to up to 0.94 and improved positive predictive value at a given sensitivity (by up to 18%). The KMCM detected AF with 83% sensitivity and 68% specificity. 89 KMCM recordings were “unclassified” or blank, and PRV detected AF in these with AUC values of up to 0.88. When non-AF arrhythmias (n = 56) were excluded, the KMCM device had increased specificity (73%) and PRV had higher discrimination performance (maximum AUC = 0.96). In decision curve analysis, all PRV parameters consistently achieved a positive net benefit across the range of clinical thresholds. In primary care, AF can be detected by PRV accurately and by KMCM, especially in the absence of non-AF arrhythmias or when combinations of measurements are used.John D. SluyterRobert ScraggMalakai ‘OfanoaRalph A. H. StewartNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-10 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q John D. Sluyter Robert Scragg Malakai ‘Ofanoa Ralph A. H. Stewart Atrial fibrillation detection in primary care during blood pressure measurements and using a smartphone cardiac monitor
description	Abstract Improved atrial fibrillation (AF) screening methods are required. We detected AF with pulse rate variability (PRV) parameters using a blood pressure device (BP+; Uscom, Sydney, Australia) and with a Kardia Mobile Cardiac Monitor (KMCM; AliveCor, Mountain View, CA). In 421 primary care patients (mean (range) age: 72 (31–99) years), we diagnosed AF (n = 133) from 12-lead electrocardiogram recordings, and performed PRV and KMCM measurements. PRV parameters detected AF with area under curve (AUC) values of up to 0.92. Using the mean of two sequential readings increased AUC to up to 0.94 and improved positive predictive value at a given sensitivity (by up to 18%). The KMCM detected AF with 83% sensitivity and 68% specificity. 89 KMCM recordings were “unclassified” or blank, and PRV detected AF in these with AUC values of up to 0.88. When non-AF arrhythmias (n = 56) were excluded, the KMCM device had increased specificity (73%) and PRV had higher discrimination performance (maximum AUC = 0.96). In decision curve analysis, all PRV parameters consistently achieved a positive net benefit across the range of clinical thresholds. In primary care, AF can be detected by PRV accurately and by KMCM, especially in the absence of non-AF arrhythmias or when combinations of measurements are used.
format	article
author	John D. Sluyter Robert Scragg Malakai ‘Ofanoa Ralph A. H. Stewart
author_facet	John D. Sluyter Robert Scragg Malakai ‘Ofanoa Ralph A. H. Stewart
author_sort	John D. Sluyter
title	Atrial fibrillation detection in primary care during blood pressure measurements and using a smartphone cardiac monitor
title_short	Atrial fibrillation detection in primary care during blood pressure measurements and using a smartphone cardiac monitor
title_full	Atrial fibrillation detection in primary care during blood pressure measurements and using a smartphone cardiac monitor
title_fullStr	Atrial fibrillation detection in primary care during blood pressure measurements and using a smartphone cardiac monitor
title_full_unstemmed	Atrial fibrillation detection in primary care during blood pressure measurements and using a smartphone cardiac monitor
title_sort	atrial fibrillation detection in primary care during blood pressure measurements and using a smartphone cardiac monitor
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/49520a6547414117bb78e015af223095
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Atrial fibrillation detection in primary care during blood pressure measurements and using a smartphone cardiac monitor

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