Opportunistic screening for atrial fibrillation with a single lead device in geriatric patients
Lennaert AR Zwart1
René WMM Jansen2
Jacob H Ruiter3
Tjeerd Germans3
Suat Simsek4
Martin EW Hemels5
1.Department of Geriatric Medicine, North West Clinics, Wilhelminalaan, Alkmaar, the Netherlands;Department of Geriatric Medicine, Dijklander Hospital, Maelsonstraat, Hoorn, the Netherlands2.Department of Geriatric Medicine, North West Clinics, Wilhelminalaan, Alkmaar, the Netherlands3.Department of Cardiology, North West Clinics, Wilhelminalaan, Alkmaar, the Netherlands4.Department of Internal Medicine, North West Clinics, Wilhelminalaan, Alkmaar, the Netherlands5.Department of Cardiology, Rijnstate Hospital, Arnhem, the Netherlands;Department of Cardiology, Radboud University Medical Centre, Geert Grooteplein Zuid, Nijmegen, the Netherlands
摘要：Objective To determine the diagnostic yield of repeated screening for atrial fibrillation (A.F) among geriatric patients.Methods A pragmatic prospective cohort study into applying opportunistic screening for AF with a handheld single lead ECG device (SLD) in a geriatric cohort.Consecutive patients of 65 years old and older visiting the geriatric outpatient clinic were eligible for inclusion.A 12 lead ECG was performed,followed by measurements with the SLD during every visit to the geriatric outpatient clinic.A frailty index was based on the accumulation of deficits model.Results 478 patients were eligible.Patients were excluded if they did not give informed consent (17 patients),had a pacemaker or implantable cardioverter defibrillator (20 patients),or had incomplete medical files (two patients).ARer exclusion,439 patients participated in this study.The mean age was 78 years (range 65 to 100 years),54％ were female.AF was known in 89 patients (20％),first detected on the baseline ECG in four patients (1％) and first detected with the SLD in 20 patients (5％) during follow up visits.Sensitivity of the SLD was 90.0％,specificity 99.0％,negative predictive value 99.7％,and positive predictive value 73.5％.Most patients (82％) with AF were frail and 53％ were severely frail.Conclusion Repeated screening in geriatric patients has a five times higher diagnostic yield than usual care.It was easily combined with usual care.Because of the positive predictive value of 73.5％,it remains necessary to confirm AF with a 12 lead ECG or 24-h Holter monitoring.
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论文发表日期：2020-03-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：6( 149-154 )
英文信息