Background

Untreated atrial fibrillation (AF) often results in increased morbidity and mortality. Opportunistic AF screening in persons aged ≥ 65 years is recommended to identify patients with AF in order to prevent AF-related complications.

Objective

The aim of this study was to assess the feasibility of screening persons for AF with the Kardia mobile electrocardiogram device (MED) and to determine the percentage of newly detected AF cases by selective population screening in the Netherlands.

Methods

Persons aged ≥ 65 years, without a medical history of AF, in nursing homes, at public events or visiting the general practitioner (GP) were approached to participate. A Kardia MED smartphone ECG (sECG) was recorded and the CHA₂DS₂-VASc score was calculated. An automated AF algorithm classified the sECGs as ‘sinus rhythm’, ‘AF’ or ‘unclassified’. In the case of AF, participants were referred to their GP. All sECGs were assessed by blinded experts.

Results

A total of 2168 participants were screened for AF. According to the expert’s interpretation, 2.5% had newly detected AF, of whom 76.4% never experienced palpitations and 89.1% had a CHA₂DS₂-VASc score ≥ 2. The algorithm result was unclassified in 12.2% of cases, of which 95.5% were interpretable by experts. With expert opinion as the gold standard and excluding unclassified sECGs, the Kardia MED’s negative and positive predictive value for detecting AF was 99.8% and 60.0%, respectively.

Conclusion

Screening for AF using the Kardia MED is feasible and results in 2.5% newly detected AF cases. Expert interpretation of algorithm outcomes AF and unclassified is recommended.

中文翻译：

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使用移动心电图设备检测 65 岁及以上人群的心房颤动

背景

未经治疗的心房颤动 (AF) 通常会导致发病率和死亡率增加。建议对 65 岁以上人群进行机会性 AF 筛查，以识别 AF 患者，以预防 AF 相关并发症。

客观的

本研究的目的是评估使用 Kardia 移动心电图设备 (MED) 筛查人员房颤的可行性，并确定荷兰通过选择性人群筛查新发现的房颤病例的百分比。

方法

年龄 ≥ 65 岁、无 AF 病史、在疗养院、公共活动或拜访全科医生 (GP) 的人士被邀请参加。记录 Kardia MED 智能手机心电图 (sECG) 并计算CHA ₂ DS _{2 -VASc 评分。}自动 AF 算法将 sECG 分类为“窦性心律”、“AF”或“未分类”。在房颤的情况下，参与者被转介给他们的全科医生。所有 sECG 均由盲法专家评估。

结果

共有 2168 名参与者接受了 AF 筛查。根据专家解读，2.5%的人新发现房颤，其中76.4%的人从未出现过心悸，89.1%的人CHA ₂ DS ₂ -VASc评分≥2。12.2%的病例算法结果未分类，其中95.5%并得到了专家的解读。以专家意见为金标准，排除未分类的 sECG，Kardia MED 检测 AF 的阴性和阳性预测值分别为 99.8% 和 60.0%。

结论

使用 Kardia MED 筛查 AF 是可行的，新发现 AF 病例的比例为 2.5%。建议对算法结果 AF 和未分类进行专家解释。