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Are Ambulatory Devices Accurate For Detecting Atrial Fibrillation?

Atrial fibrillation (AF) is the most prevalent heart arrhythmia, affecting roughly 33.5 million people worldwide. AF becomes increasingly common with age, and its frequency is anticipated to double by 2030.

Although typically asymptomatic, the condition can cause significant morbidity and mortality by raising the risk of heart failure, stroke, major cardiovascular events, sudden cardiac death, and worsen existing chronic renal disease, peripheral arterial disease, and all-cause mortality.

A variety of therapeutic options, such as anticoagulation, rate control, and rhythm control via medication or electrical cardioversion, can significantly minimize risks and alleviate symptoms.



Need for Ambulatory Devices in Detecting Atrial Fibrillation

Despite the fact that AF treatment is well established due to multiple guidelines and clinical trials, detecting the condition remains difficult. The 12-lead electrocardiogram is the gold standard for detecting AF (ECG)

However, this approach is not always available and may be impractical in certain patient groups, such as those with paroxysmal AF who fail to obtain a 12-lead ECG in a timely manner or those with silent (subclinical) AF with no associated symptoms. As a result, technologies that are convenient, affordable, and ambulatory are necessary to act as preliminary screening tools; early diagnoses can then be verified or excluded in hospital settings using the gold standard 12-lead ECG.


Review of Ambulatory Devices for Detecting Atrial Fibrillation

Several research studies have been conducted in recent years to explore the accuracy and usefulness of various ambulatory devices.

The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) criteria were followed for conducting the systematic review and meta-analysis. The full-text evaluation produced 16 publications that matched the inclusion criteria; these studies were included in the current systematic review and meta-analysis. All of the studies included had a prospective design with a total of 3217 participants. Thirteen of the 16 papers were studies with 44 to 418 participants.

Four of the research articles excluded participants over the age of 65, while four studies only included patients with an AF diagnosis or history. These four articles identified patients with AF and added control members to the cohort. The remaining seven studies enrolled in-hospital patients with varied diagnoses, while one research enrolled sports, students, and ambulatory cardiology clinic patients.

The prevalence of atrial fibrillation among study participants ranged from 5% to 100%.

The 16 studies looked into two technologies: non-12-lead ECG and PPG. Non-12-lead ECG measurements are defined in this review as any electrode-based device measurements; participants simply placed their fingers on the electrodes, affixed the electrodes to their chest, or held the electrodes in their hands. PPG is a technology that measures changes in tissue blood volume, allowing each heartbeat to be recorded; the signal may be recognized by any device with a camera that monitors various body parts, such as the fingertip, wrist, palm, and face.

Accuracy of Ambulatory Devices in Detecting Atrial Fibrillation

The meta-analysis concluded that both non-12-lead ECG and PPG methods provided accurate diagnoses of AF. When compared to both manual and automatic interpretations of non-12-lead ECG, automatically interpreted PPG recordings produced the highest sensitivity and specificity. Detection of AF using automatic analytic approaches may be a useful preliminary screening tool prior to delivering a gold standard test, which normally necessitates analysis by experienced clinicians.

ViSi Mobile is an FDA-approved continuous ambulatory device system that offers atrial fibrillation, ventricular fibrillation, ventricular tachycardia, and asystole analysis and alarming, providing clinicians early detection and timely intervention capabilities for a condition that often goes undetected. Additionally, it monitors patient's vital signs including the following: (Pulse Rate, Heart Rate (3 ECG Lead and 5 ECG Lead), SpO2, cNIBP (Continuous Non-Invasive Blood Pressure), MAP, Respiration Rate, Skin Temperature, Posture, and Fall Detection. 

This device is designed to improve patient safety by detecting early signs of deterioration in virtually any care setting, enabling early intervention and rapid response without limiting the patient’s freedom of movement. Find the full list of studies and papers relating to the Sotera Wireless wearable medical alert device here.

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Filed Under: Atrial Fibrillation