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Opportunistic detection of atrial fibrillation using blood pressure monitors: a systematic review

Kane, Sarah A; Blake, James R; McArdle, Frank J; Langley, Philip; Sims, Andrew J

Authors

Sarah A Kane

James R Blake

Frank J McArdle

Andrew J Sims



Abstract

Background: Atrial Fibrillation (AF) affects around 2% of the population and early detection is beneficial, allowing patients to begin potentially life-saving anticoagulant therapies. Blood pressure (BP) monitors may offer an opportunity to screen for AF. Aim: To identify and appraise studies which report the diagnostic accuracy of automated BP monitors used for opportunistic AF detection. Methods: A systematic search was performed of the Medline, Medline-in-process and Embase literature databases. Papers were eligible if they described primary studies of the evaluation of a BP device for AF detection, were published in a peer reviewed journal and reported values for the sensitivity and specificity. Included studies were appraised using the QUADAS-2 tool to assess their risk of bias and applicability to opportunistic AF detection. Values for the sensitivity and specificity of AF detection were extracted from each paper and compared. Results and Conclusion: We identified seven papers evaluating six devices from two manufacturers. Only one study scored low risk in all of the QUADAS-2 domains. All studies reported specificity greater than 85% and six reported sensitivity greater than 90%. The studies showed that blood pressure devices with embedded algorithms for detecting arrhythmias show promise as screening tools for AF, comparing favourably with manual pulse palpation. But the studies used different methodologies and many were subject to potential bias. More studies are needed to more precisely define the sensitivity and specificity of opportunistic screening for AF during blood pressure measurement before its clinical utility in the population of interest can be assessed fully.

Publication Date 2016-04
Journal Open heart
Electronic ISSN 2053-3624
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 3
Issue 1
Pages e000362
APA6 Citation Kane, S. A., Blake, J. R., McArdle, F. J., Langley, P., & Sims, A. J. (2016). Opportunistic detection of atrial fibrillation using blood pressure monitors: a systematic review. Open heart, 3(1), e000362. https://doi.org/10.1136/openhrt-2015-000362
DOI https://doi.org/10.1136/openhrt-2015-000362
Keywords Systematic review; Atrial fibrillation; Opportunistic Screening
Publisher URL http://openheart.bmj.com/content/3/1/e000362
Copyright Statement This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Additional Information Copy of article first published in: Open heart, 2016, v.3, issue 1.

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Copyright Statement
This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/



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