ATRIAL FIBRILLATION DETECTION DURING AUTOMATED BLOOD PRESSURE MEASUREMENT: A SYSTEMATIC REVIEW AND META-ANALYSIS. (June 2018)

• Record Type: Journal Article
• Authors: Kyriakoulis, K.; Kollias, A.; Stambolliu, E.; Stergiou, G.S.
• Is Part Of: Journal of hypertension. Volume 36(2018)Supplement 1
• Publication Date: 2018-06
• Subjects: Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/01.hjh.0000539129.59055.ff
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objective: In 2013 the UK National Institute for Health and Care Excellence (NICE) recommended opportunistic atrial fibrillation (AF) screening during routine office blood pressure (BP) measurement using the oscillometric Microlife Afib BP monitor with specific AF detection algorithm in primary care in the elderly. This study evaluated the current evidence on the diagnostic accuracy of this technology in detecting AF during automated BP measurement. Design and method: A systematic PubMed search was conducted using the keywords "atrial fibrillation", "blood pressure", "detection", "screening". Results: Initial search retrieved 258 articles of which 13 were relevant. Eleven articles evaluated the diagnostic accuracy of BP monitors during office measurements, and 2 during home BP measurements. Electrocardiography was used as reference method in all studies. A meta-analysis of 11 studies with adequate data (n = 10, 972; AF prevalence 17 ± 12%; 4 studies required at least 2 of 3 AF positive readings for AF diagnosis) showed pooled sensitivity, specificity and accuracy as follows: 95% (95% C.I. 92–98%), 94% (92–96) and 94% (93–96), respectively. With increasing AF prevalence across studies, meta-regression analysis showed a trend towards higher sensitivity and lower specificity. Conclusions: The available evidence suggests that AF detection during automated BP measurement using the Microlife Afib device has high diagnostic accuracy, which is influenced by the AF prevalence. These data support the 2013 UK NICE recommendation for AF screening using automated BP measurement with specific AF detecting algorithm in the elderly.