title: [Validation of taking arterial pulse in Primary Care for the detection of atrial fibrillation and other cardiac rhythm disorders in patients over 65 years old].
abstract: BACKGROUND
  Atrial fibrillation (AF) is the most frequent arrhythmia in clinical practice and has important prognostic implications. The objective of this study was to demonstrate the validity and the reliability of taking the arterial pulse (TAP) in patients over 65 years for detecting in AF and other rhythm disorders.
  
  
  METHODS
  A descriptive, observational, multicentre study to validate a diagnostic test within in a controlled clinical trial.
  
  
  METHODS
  39 Primary Care Centres in the Spanish National Health Service. A total of 318 physicians and nurses took part in the analysis of validity, and 166 of them took part in the analysis of reliability. The professionals were previously called to a meeting in which they took the arterial pulses, and were given 4 ECGs to interpret. The participants TAP of 864 patients followed by an ECG to confirm the cardiac rhythm. Sensitivity, specificity and predictive values were estimated to assess the criterial validity and the simple concordance index to check reproducibility.
  
  
  RESULTS
  The sensitivity of pulse measurement for detecting AF detection was 99.4% (95% CI: 97.9-100.0), with a specificity of 30.7% (95% CI: 26.1-35.3), a positive predictive value of 36.6% (95% CI 32.0-41.2), and negative predictive value of 99.2% (97.3-100.0). The simple concordance between the researchers and the cardiologist for the ECG diagnosis of AF ranged between 84.9% and 91.6%.
  
  
  CONCLUSIONS
  The TAP has a high sensitivity but a low specificity to detect AF. It is a reliable test for the opportunistic screening of arrhythmias in patients aged over 65 years.
authors: Unidad Docente de Medicina Familiar y Comunitaria de Córdoba, Distrito Sanitario Córdoba y Guadalquivir, Córdoba, España; Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, España. Electronic address: luisangel.perula@gmail.com.
authors: L A
authors: LA
authors: Pérula-de Torres
authors: Unidad Docente de Medicina Familiar y Comunitaria de Córdoba, Distrito Sanitario Córdoba y Guadalquivir, Córdoba, España.
authors: V
authors: V
authors: González-Blanco V
authors: Unidad Docente de Medicina Familiar y Comunitaria de Córdoba, Distrito Sanitario Córdoba y Guadalquivir, Córdoba, España.
authors: R
authors: R
authors: Luque-Montilla
authors: Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, España; Centro de Salud/UGC Fuensanta, Córdoba, España.
authors: E
authors: E
authors: Martín-Rioboó
authors: Centro de Salud Argentona, Consorci Sanitari del Maresme, Argentona, Barcelona, España.
authors: M A
authors: MA
authors: Martínez-Adell
authors: Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía, Universidad de Córdoba, Córdoba, España; Servicio de Cardiología, Hospital Regional Universitario Reina Sofía, Córdoba, España.
authors: J
authors: J
authors: Ruiz-de Castroviejo
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000175:diagnosis*; D001281:Atrial Fibrillation / Q000175:diagnosis*; D004562:Electrocardiography; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013030:Spain
keywords: Atrial fibrillation; Fibrilación auricular; Pulse taking; Toma de pulso arterial; Validación; Validation