Diagnostic accuracy of a novel cuffless self-blood pressure monitor for atrial fibrillation screening in the elderly
Diagnostic accuracy of a novel cuffless self-blood pressure monitor for atrial fibrillation screening in the elderly
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DOI：
10.1111/jch.13730
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发表时间：
2019-11-19
影响因子：
2.8
通讯作者：
Stergiou, George S.
中科院分区：
文献类型：
--
作者：
Kyriakoulis, Konstantinos G.;Kollias, Anastasios;Stergiou, George S.
配备房颤检测算法的血压监测仪是老年高血压患者房颤的有吸引力的筛查工具。这项研究评估了一种新型的无袖袖珍自体血压监测仪(Freescan，Maisense)的诊断准确性，该监测仪配备了房颤检测算法，可以显示常规血压测量中检测到的“房颤”或“心律失常”的结果。65岁或60-65岁患有高血压、糖尿病或心血管疾病的受试者接受了使用Freescan设备同时进行连续动态心电监测的血压测量。丢弃带有设备通知“不稳定”(29%)或“错误”(20%)的读数。分析了136名接受5次有效血压测量的受试者(年龄73.8+/-7.1岁，男性63%，高血压治疗88%，心电图房颤21%)的数据。对680例Freescan读数与心电图的分析显示，房颤诊断的特异度为99%，敏感度为67%，诊断准确率为93%。当“心律失常”被认为是房颤诊断时，敏感性提高(分别为93%、96%和93%)。对受试者的房颤诊断的分析(诊断定义为至少五个读数中的三个表示“房颤”或“心律失常”)显示房颤检测的特异度、敏感度和诊断准确率分别为94%、100%和95%。这些数据表明，Freescan无袖装置可以作为老年人常规自测血压时检测房颤的有用筛查工具。
Blood pressure (BP) monitors equipped with atrial fibrillation (AF) detection algorithm are attractive screening tools for AF in elderly hypertensives. This study assessed the diagnostic accuracy of a novel cuffless pocket-size self-BP monitor (Freescan, Maisense) equipped with an AF detection algorithm, which displays results for the detection of "AF" or "Arrhythmia" during routine BP measurement. Subjects aged >65 years or 60-65 years with hypertension, diabetes, or cardiovascular disease were subjected to BP measurements using the Freescan device with simultaneous continuous Holter electrocardiography (ECG) monitoring. Readings with device notification "Instability" (29%) or "Error" (20%) were discarded. Data from 136 subjects with five valid Freescan BP measurements were analyzed (age 73.8 +/- 7.1 years, males 63%, treated hypertensives 88%, AF in ECG 21%). Analysis of 680 Freescan readings vs ECG revealed specificity 99%, sensitivity 67%, and diagnostic accuracy 93% for AF diagnosis. When the "Arrhythmia" notification was considered as AF diagnosis, the sensitivity was improved (93%, 96%, and 93%, respectively). Analysis of AF diagnosis in subjects (diagnosis defined as at least three of five readings indicating "AF" or "Arrhythmia") revealed specificity, sensitivity, and diagnostic accuracy for AF detection at 94%, 100%, and 95%, respectively. These data suggest that the Freescan cuffless device could be used as a useful screening tool for AF detection during routine self-measurement of BP in the elderly.