Can we improve the early detection of atrial fibrillation in a stroke unit? Detection rate of a monitor with integrated detection software. (February 2016)

• Record Type: Journal Article
• Authors: Arevalo-Manso, Juan Jose; Martínez-Sánchez, Patricia; Fuentes, Blanca; Ruiz-Ares, Gerardo; Sanz-Cuesta, Borja Enrique; Prefasi, Daniel; Juarez-Martin, Belén; Navarro-Parias, Azahara; Parrilla-Novo, Pilar; Diez-Tejedor, Exuperio
• Is Part Of: European journal of cardiovascular nursing. Volume 15:Number 1(2016)
• Page Start: 64
• Page End: 71
• Publication Date: 2016-02
• Subjects: Atrial fibrillation -- electrocardiography -- cardiac monitoring -- brain infarction -- stroke unit; Cardiovascular system -- Diseases -- Nursing -- Periodicals; Cardiovascular Diseases -- nursing -- Periodicals; Cardiology -- Periodicals; Nursing -- Periodicals; Vascular Diseases -- Periodicals; 610.7369105
• DOI: 10.1177/1474515114552043
• Languages: English
• ISSNs: 1474-5151

Abstract

Introduction: It is unknown whether monitors that include atrial fibrillation recognition software (AF-RS) increase the rate of early atrial fibrillation (AF) detection in acute stroke. We aimed to evaluate the AF detection rate of an AF-RS monitor and compare it with standard monitoring. Methods: This was a retrospective, single-centre observational study conducted on consecutive patients with acute transient ischaemic attack or brain infarction attended in a stroke unit (SU) with six beds. Five beds had a standard monitor with a three-lead electrocardiogram (ECG)-tracing monitor that did not automatically detect AF, and one bed had a 12-lead ECG monitor with integrated AF-RS. All patients were monitored for at least 24 h and underwent a daily ECG during their stay in the SU. In case of unknown stroke aetiology, the patients underwent 24 h Holter monitoring. Results: A total of 76 patients were included: 59 patients in the standard monitor group and 17 patients in the AF-RS monitor group. The mean age was 72.11 (±13.09) years, and 59.2% were men. A total of 20 new cases of AF were identified. The AF-RS monitor showed a higher rate of AF detection than the standard devices (57.1% vs 7.7%, p =0.031). The AF-RS monitor showed sensitivity, specificity, positive predictive value, and negative predictive values of 57.1%, 100%, 100% and 76.9%, respectively. For the standard monitors, these values were 7.7%, 100%, 100% and 79.3%, respectively. Conclusion: The monitor with AF-RS demonstrated a higher detection rate for AF than standard ECG monitoring in acute stroke patients in a SU.