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Diagnostic accuracy of a home blood pressure monitor to detect atrial fibrillation

Journal of Human Hypertension volume 23, pages 654–658 (2009)Cite this article

Abstract

Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with an increased long-term risk of stroke. A screening test for early diagnosis has the potential to prevent AF-related strokes. This study assessed the diagnostic accuracy of an automated device for self-home blood pressure (BP) monitoring, which implements an algorithm for AF detection. A modified, automated oscillometric device for self-home BP monitoring (Microlife BPA100 Plus, Microlife, Heerbrugg, Switzerland) with an AF detector was used to carry out triplicate BP measurements in subjects with sinus rhythm, AF and non-AF arrhythmias. During each BP measurement, the electrocardiogram (ECG) was recorded simultaneously. A total of 217 simultaneous BP measurements and ECG recordings were obtained from 73 subjects. Twenty-seven subjects (37%) had AF, 23 (31%) non-AF arrhythmias and 23 (31%) had sinus rhythm. A single measurement had 93% sensitivity and 89% specificity for detecting AF. For two measurements, in which one of them was required to detect AF, the sensitivity was 100% and specificity 76%, whereas for three measurements, in which two of them were required to detect AF, the sensitivity was 100% and specificity 89% (κ=0.86 for an agreement with ECG). Using the latter approach, there were five false positive cases all having irregularities in ∼50% of the heartbeats. In patients with tachyarrhythmia, the device underestimated heart rate. These data suggest that an electronic device for self-home BP monitoring, which implements an algorithm for AF diagnosis has an excellent diagnostic accuracy and might, therefore, be used as a reliable screening test for the early diagnosis.

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Acknowledgements

This study was funded by the Hypertension Center, Third University Department of Medicine, Athens.

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Authors and Affiliations

  1. Third University Department of Medicine, Hypertension Center, Sotiria Hospital, Athens, Greece

    G S Stergiou, N Karpettas, A Protogerou, E G Nasothimiou & M Kyriakidis

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  1. G S Stergiou
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  2. N Karpettas
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  3. A Protogerou
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  4. E G Nasothimiou
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  5. M Kyriakidis
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Corresponding author

Correspondence to G S Stergiou.

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Conflict of interest

The Hypertension Center has received grants from the manufacturer of the tested device (Microlife) for other research activities. GSS was a consultant to Microlife for the design of other blood pressure monitors. Microlife was not involved in the esign of this study.

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Stergiou, G., Karpettas, N., Protogerou, A. et al. Diagnostic accuracy of a home blood pressure monitor to detect atrial fibrillation. J Hum Hypertens 23, 654–658 (2009). https://doi.org/10.1038/jhh.2009.5

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