title: Opportunistic screening of atrial fibrillation by automatic blood pressure measurement in the community.
abstract: OBJECTIVE
  Timely detection of atrial fibrillation (AF) may effectively prevent cardiovascular consequences. However, traditional diagnostic tools are either poorly reliable (pulse palpation) or not readily accessible (ECG) in general practice. We tested whether an automatic oscillometric blood pressure (BP) monitor embedded with an algorithm for AF detection might be effective for opportunistic screening of asymptomatic AF in the community.
  
  
  METHODS
  A community-based screening campaign in an unselected population to verify the feasibility of AF screening with a Microlife WatchBP Office BP monitor with a patented AFIB algorithm. When possible AF was detected (≥2 of 3 BP measurements reporting AF), a doctor immediately performed a single-lead ECG in order to confirm or exclude the presence of the arrhythmia. The main demographic and clinical data were also collected.
  
  
  METHODS
  220 consecutive participants from an unselected sample of individuals in a small Italian community.
  
  
  METHODS
  Number of patients detected with AF and diagnosed risk factors for AF.
  
  
  RESULTS
  In 12 of 220 participants, the device detected possible AF during the BP measurement: in 4 of them (1.8%), the arrhythmia was confirmed by the ECG. Patients with AF were more likely to be older (77.0±1.2 vs 57.2±15.2 years, p=0.010), obese (50.0 vs 14.4%, p=0.048) and to suffer from a cardiovascular disease (50.0 vs 10.6%, p=0.014) than patients without AF. Participants with a positive BP AF reading and non-AF arrhythmias (n=8) did not differ in their general characteristics from participants with a negative BP AF reading and were younger than patients with AF (mean age 56.4±14.8, p=0.027; 5 of 8 participants aged <65 years).
  
  
  CONCLUSIONS
  Opportunistic screening of AF by BP measurement is feasible to diagnose this arrhythmia in unaware participants, particularly in those older than 65 years, who are the target patient group recommended by current AF screening guidelines.
authors.affiliation: Clinical Research Unit, Italian Institute of Telemedicine, Varese, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Omboni
authors.affiliation: Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands Microlife AG, Widnau, Switzerland.
authors.forename: Willem J
authors.initials: WJ
authors.lastname: Verberk
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001281:Atrial Fibrillation / Q000175:diagnosis*; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory / Q000295:instrumentation / Q000379:methods; D003153:Community Health Services; D003935:Diagnostic Techniques, Cardiovascular / Q000295:instrumentation; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009991:Oscillometry; D010820:Physicians; D012111:Residence Characteristics; D019722:Sphygmomanometers; D055815:Young Adult
keywords: Atrial fibrillation; Blood pressure measurement; Italy