title: Peripheral pulse measurement after ischemic stroke: A feasibility study.
abstract: OBJECTIVE
  To investigate feasibility and diagnostic accuracy of measurement of the peripheral pulse (MPP) at the radial artery as a simple, noninvasive screening tool for paroxysmal atrial fibrillation (pAF) in patients after acute ischemic stroke.
  
  
  METHODS
  Two hundred fifty-six patients with acute ischemic stroke and the patients' relatives at a tertiary stroke center were prospectively included. Participants were instructed for characteristics of atrial fibrillation (AF) in MPP using standardized educational material. Measurements of participants as well as a health care professional were then compared with simultaneous blinded ECG to evaluate diagnostic accuracy parameters.
  
  
  RESULTS
  MPP by the health care professional or patients' relatives had a diagnostic sensitivity of 96.5% and 76.5%, respectively, with 94.0% and 92.9% specificity for the detection of AF. Self-measurements were reliably performed by 89.1% of competent patients with a diagnostic sensitivity of 54.1% and 96.2% specificity. False-positive results were limited to 6 cases (2.7%) with a positive predictive value of 76.9% and a negative predictive value of 90.0%.
  
  
  CONCLUSIONS
  With a low rate of false-positive results, MPP offers an easy, ubiquitously available, noninvasive, first-step screening tool to guide ECG diagnostics for pAF after ischemic stroke. The data warrant a prospective trial evaluating the efficacy of MPP-guided ECG diagnostics in secondary prevention after stroke, which is now underway.
  
  
  METHODS
  This study provides Class I evidence that MPP by patients or relatives accurately distinguishes AF from normal heart rhythm as compared with continuous ECG.
authors: From the Department of Neurology, Universitätsklinikum Erlangen, Germany. bernd.kallmuenzer@uk-erlangen.de.
authors: Bernd
authors: B
authors: Kallmünzer
authors: From the Department of Neurology, Universitätsklinikum Erlangen, Germany.
authors: Tobias
authors: T
authors: Bobinger
authors: From the Department of Neurology, Universitätsklinikum Erlangen, Germany.
authors: Nicolas
authors: N
authors: Kahl
authors: From the Department of Neurology, Universitätsklinikum Erlangen, Germany.
authors: Markus
authors: M
authors: Kopp
authors: From the Department of Neurology, Universitätsklinikum Erlangen, Germany.
authors: Natalia
authors: N
authors: Kurka
authors: From the Department of Neurology, Universitätsklinikum Erlangen, Germany.
authors: Max-Josef
authors: MJ
authors: Hilz
authors: From the Department of Neurology, Universitätsklinikum Erlangen, Germany.
authors: Lars
authors: L
authors: Marquardt
authors: From the Department of Neurology, Universitätsklinikum Erlangen, Germany.
authors: Stefan
authors: S
authors: Schwab
authors: From the Department of Neurology, Universitätsklinikum Erlangen, Germany.
authors: Martin
authors: M
authors: Köhrmann
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000209:etiology* / Q000503:physiopathology; D002545:Brain Ischemia / Q000150:complications*; D004562:Electrocardiography; D005189:False Positive Reactions; D005240:Feasibility Studies; D005260:Female; D006321:Heart / Q000503:physiopathology; D006801:Humans; D008297:Male; D011446:Prospective Studies; D011674:Pulse; D017534:Radial Artery / Q000503:physiopathology*; D012648:Self Care; D012680:Sensitivity and Specificity; D020521:Stroke / Q000150:complications*