Intermittent vs continuous electrocardiogram event recording for detection of atrial fibrillation—Compliance and ease of use in an ambulatory elderly population. Issue 4 (9th January 2020)

• Record Type: Journal Article
• Authors: Fredriksson, Tove; Kemp Gudmundsdottir, Katrin; Frykman, Viveka; Friberg, Leif; Al‐Khalili, Faris; Engdahl, Johan; Svennberg, Emma
• Is Part Of: Clinical cardiology. Volume 43:Issue 4(2020)
• Page Start: 355
• Page End: 362
• Publication Date: 2020-01-09
• Subjects: ambulatory ECG -- atrial fibrillation -- electrocardiography -- epidemiology; Cardiology -- Periodicals; 616.12005
• DOI: 10.1002/clc.23323
• Languages: English
• ISSNs: 0160-9289

Abstract

Abstract: Background: There are many atrial fibrillation (AF) screening devices available. Validation studies have mainly been performed in optimal settings in the young population. Hypothesis: We aim to compare the yield of AF detection, compliance, and patient‐based experience in an ambulatory elderly population by using intermittent electrocardiogram (ECG) recordings and continuous event recording simultaneously. Methods: The study participants were part of the STROKESTOP II study, a Swedish screening study for AF. All participants were 75/76 years of age, were clinically free of AF, and had N‐terminal pro b‐type natriuretic peptides levels ≥125 ng/L. AF screening was performed in parallel during a 2‐week period, using a continuous event recording device (R‐test 4; Novacor) and 30‐second intermittent recordings using a handheld ECG device (Zenicor II) four times daily. Participants were asked to fill out a questionnaire with regard to compliance and ease of use of the devices. Results: During continuous event recording, 6% (n = 15/269) were diagnosed with AF and intermittent ECG detected AF in 2% (n = 5/269) of the participants ( P = .002). No new cases of AF were detected using intermittent ECG monitoring only, but some episodes were detected in parallel for patients. On a graded ordinal scale of 1 to 5, with 1 reflecting "very easy to use", continuous monitoring was graded 2 (interquartile range [IQR]: 1‐3) compared to intermittent 1 (IQR: 1‐1) ( P < .001). Conclusion: Continuous event recording detected three times more AF compared to intermittent ECG in an elderly ambulatory population. Compliance and user‐friendliness were rated higher for the intermittent ECG device.