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Lown M, Yue AM, Shah BN, Corbett SJ, Lewith G, Stuart B, Garrard J, Brown M, Little P, Moore M. Screening for Atrial Fibrillation Using Economical and Accurate Technology (From the SAFETY Study). Am J Cardiol 2018; 122:1339-1344. [PMID: 30131106 DOI: 10.1016/j.amjcard.2018.07.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 07/02/2018] [Accepted: 07/03/2018] [Indexed: 11/19/2022]
Abstract
The prevalence of atrial fibrillation (AF) is estimated at more than 3% in the adult population and there has been increased interest in screening for AF. In the SAFETY trial we chose to evaluate if inexpensive, wearable, consumer electrocardiography (ECG) sensing devices (Polar-H7 [PH7] and Firstbeat Bodyguard 2 [BG2]), could be used to detect AF accurately. We undertook a case-control study of 418 participants aged >65 (82 with AF and/or flutter at the study visit and 336 without) attending 3 general practice surgeries in Hampshire, UK for a single screening visit. The PH7 and BG2 devices were tested alongside 2 established AF detection devices (AliveCor and WatchBP) in random order and the diagnosis of AF was confirmed by 12-Lead ECG interpreted by a panel of cardiologists. The sensitivity (95% confidence interval [CI] range), specificity (95% CI range), and overall accuracy (95% CI range) of the 4 devices were: AliveCor: 87.8% (78.7% to 94.0%), 98.8% (97.0% to 99.7%), 96.7% (94.4% to 98.2%); WatchBP: 96.3% (89.7% to 99.2%), 93.5% (90.3% to 95.9%), 94.0% (91.3% to 96.1%): PH7: 96.3% (89.7% to 99.2%), 98.2% (96.2% to 99.3%), 97.9% (96.0% to 99.0%). BG2: 96.3% (89.7% to 99.2%), 98.5% (96.6% to 99.5%), 98.1% (96.3% to 99.2%). The PH7 and BG2 devices were highly reliable (the devices acquired sufficient data and obtained a diagnostic result in all but 1 participant on the first attempt). In conclusion, inexpensive, consumer heart rate monitoring devices (PH7 and BG2) can be used to detect AF accurately with sensitivity and specificity >95%. The consumer devices performed as well or better than WatchBP and AliveCor and have the capability to store or transmit ECG data which could be used to confirm AF.
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Affiliation(s)
- Mark Lown
- Primary Care & Population Sciences, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST, United Kingdom.
| | - Arthur M Yue
- Cardiology and Electrophysiology, Southampton General Hospital, Southampton SO16 6YD, United Kingdom
| | - Benoy N Shah
- Cardiology and Electrophysiology, Southampton General Hospital, Southampton SO16 6YD, United Kingdom
| | - Simon J Corbett
- Cardiology and Electrophysiology, Southampton General Hospital, Southampton SO16 6YD, United Kingdom
| | - George Lewith
- Primary Care & Population Sciences, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST, United Kingdom
| | - Beth Stuart
- Primary Care & Population Sciences, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST, United Kingdom
| | - James Garrard
- Primary Care & Population Sciences, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST, United Kingdom
| | - Michael Brown
- Head of Engineering Projects Leonardo MW Ltd., United Kingdom
| | - Paul Little
- Primary Care & Population Sciences, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST, United Kingdom
| | - Michael Moore
- Primary Care & Population Sciences, Faculty of Medicine, University of Southampton, Aldermoor Health Centre, Southampton SO16 5ST, United Kingdom
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