Home monitoring with a modified automatic sphygmomanometer to detect recurrent atrial fibrillation.
OBJECTIVE
Detecting asymptomatic atrial fibrillation would help identify patients who would benefit from anticoagulation. This study examined the application of a modified blood pressure monitor to screen for episodes of atrial fibrillation.


METHODS
A modified sphygmomanometer was designed to detect atrial fibrillation. The device has a sensitivity near 100% and a specificity of up to 91%. Therefore, this device can be expected to detect all episodes of atrial fibrillation. However, the lower specificity may result in false-positive readings that could prompt unnecessary clinic visits for electrocardiogram confirmation of the rhythm. Outpatients in sinus rhythm with a history of atrial fibrillation were given the device to monitor their pulse regularity once daily to detect atrial fibrillation. Patients with irregular readings were evaluated with an electrocardiogram.


RESULTS
Nineteen patients were monitored at home for a period ranging from 5 days to 5 months. Seven patients had recurrent atrial fibrillation identified by the monitor. Nine patients had no irregular readings for a mean of 82 +/- 40 days. Of 19 patients, 3 had false-positive irregular readings that were a result of sinus arrhythmia or ectopy.


CONCLUSIONS
The device had an acceptably low false-positive rate allowing 16 of 19 patients to use it at home for long-term atrial fibrillation monitoring. This device may help prevent strokes by identifying patients with prolonged episodes of asymptomatic atrial fibrillation who are candidates for anticoagulation.
Wiesel
Joseph
J
New York Hospital Queens, Flushing, New York 11355, USA.
Wiesel
David J
DJ
Messineo
Frank C
FC
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D001282:Atrial Flutter / Q000175:diagnosis; D004562:Electrocardiography; D004867:Equipment Design; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D020766:Intracranial Embolism / Q000209:etiology / Q000517:prevention & control; D008297:Male; D011674:Pulse / Q000295:instrumentation* / Q000379:methods; D012008:Recurrence; D012648:Self Care / Q000295:instrumentation*; D012680:Sensitivity and Specificity; D019722:Sphygmomanometers
D000925:Anticoagulants