Programme no. 454-P
Quality Improvement
The use of a Handheld ECG Monitor to detect atrial fibrillation in General Practice
Brintha Jeyam*1, Sam Riahi2, Anne Kristensen*3, Martin Bach Jensen4
1Research Unit for General Practice in the North Denmark Region,Aalborg,Denmark, 2Department of Clinical Medicine, Aalborg University, Denmark,Aalborg University Hospital,Aalborg,Denmark, 3Research Unit for General Practice in the North Denmark Region,Aalborg,Denmark, 4Department of Clinical Medicine, Aalborg University, Denmark,Research Unit for General Practice in the North Denmark Region,Aalborg,Denmark
* = Presenting author
Objectives: To evaluate the effectiveness of using a HEM device in a GP clinic to detect AF.
Background: It is important to identify and treat patients with atrial fibrillation (AF) to reduce the risk of stroke. However, disabled patients may not be able to come to the general practice (GP) clinic for a normal 12-lead ECG. We do not know if an inexpensive portable Handheld ECG Monitor (HEM) could be used to identify patients with AF instead a 12-lead ECG.
Results: We expect to include 100 patients and have obtained data on 77 patients. Based on the 77 patients the preliminary results are: The mean (SD) age was 64,2 years and 38 (49,4%) were women. Their most common main diagnoses were hypertension (56%), diabetes mellitus (18%) and atrial fibrillation (23%). Of the 77 patients 7 recordings obtained with the HEM device were initially classified as AF patients, of whom 6 patients were confirmed to have AF on the ECG reading by the cardiologist (SR). It is expected that all data will be analyzed by February 2015.
Material/Methods: From April 2014 we have included patients who came to the GP clinic “Lægerne Sløjfen”, Aalborg, Denmark for a routine health assessment including an ECG. Excluded were patients with severe dementia, mental illness or poor ECG readings. After the patients had given informed consent a standard 12-lead ECG (Cardiax PC-ECG) was recorded and simultaneously a 3-lead recording using a HEM device (Handheld ECG monitor, Beijing Choice Electronic Technology Co, Ltd, Beijing, China) was registered. The HEM recordings were analyzed blinded for the results of the ECG recordings and vice versa. Disagreement was settled by a cardiologist (SR). The proportion of technically acceptable HEM recordings as well as the sensitivity and specificity in relation to detecting AF was calculated.
Conclusion: An inexpensive portable HEM device may improve diagnosing AF on frail patients who may not be able to come to the GP clinic. The forthcoming analysis of data will provide us the sensitivity and specificity of the HEM recordings compared with a standard 12-lead ECG recording.
Points for discussion: If the HEM recordings are suitable for detecting AF it may be used as a standard diagnostic tool in primary care. However, further studies are needed to evaluate the usefulness of the HEM device in GP clinics and examine the consequences of early diagnosis and treatment in these patients.