scholarly journals Performance of pulse palpation compared to one‐lead ECG in atrial fibrillation screening

2021 ◽  
Author(s):  
Katrin Kemp Gudmundsdottir ◽  
Tove Fredriksson ◽  
Emma Svennberg ◽  
Faris Al‐Khalili ◽  
Leif Friberg ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Pulse Palpation

scholarly journals Electrocardiographic screening in primary care for cardiovascular disease risk and atrial fibrillation

2019 ◽  
Vol 20 ◽  
Author(s):  
Ralf E. Harskamp
Keyword(s):  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Primary Care ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Diagnostic Testing ◽  
Routine Care ◽  
Pulse Palpation ◽  
Primary Care Patients ◽  
Ecg Abnormalities

Abstract Electrocardiograms (ECGs) are frequently recorded in primary care for screening purposes. An ECG is essential in diagnosing atrial fibrillation, and ECG abnormalities are associated with cardiovascular events. While recent studies show that ECGs adequately reclassify a proportion of patients based on the clinical risk score calculations, there are no data to support that this also results in improved health outcomes. When applied for screening for atrial fibrillation, more cases are found with routine care, but this would be undone when physicians would perform systematic pulse palpation. In most studies, the harms of routine ECG use (such as unnecessary diagnostic testing, emotional distress, increased health expenses) were poorly documented. As such, the routine performing of ECGs in asymptomatic primary care patients, whether it is for cardiovascular disease risk assessment or atrial fibrillation, cannot be recommended.

scholarly journals Reliability of pulse palpation in the detection of atrial fibrillation in an elderly population

2017 ◽  
Vol 35 (3) ◽  
pp. 293-298 ◽  
Author(s):  
Jussi Jaakkola ◽  
Tuija Vasankari ◽  
Raine Virtanen ◽  
K. E. Juhani Airaksinen
Keyword(s):  
Atrial Fibrillation ◽  
Elderly Population ◽  
Pulse Palpation

scholarly journals Validity of daily self-pulse palpation for atrial fibrillation screening in patients 65 years and older: A cross-sectional study

PLoS Medicine ◽  
2020 ◽  
Vol 17 (3) ◽  
pp. e1003063 ◽  
Author(s):  
Faris Ghazal ◽  
Holger Theobald ◽  
Mårten Rosenqvist ◽  
Faris Al-Khalili
Keyword(s):  
Atrial Fibrillation ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pulse Palpation

Screening to identify unknown atrial fibrillation

2013 ◽  
Vol 110 (08) ◽  
pp. 213-222 ◽  
Author(s):  
Nicole Lowres ◽  
Lis Neubeck ◽  
Julie Redfern ◽  
S. Ben Freedman
Keyword(s):  
Atrial Fibrillation ◽  
Stroke Risk ◽  
Oral Anticoagulant Therapy ◽  
Adult Population ◽  
Grey Literature ◽  
Age Groups ◽  
Medical Databases ◽  
Pulse Palpation ◽  
Screening Strategies ◽  
Single Time Point

SummaryAtrial fibrillation (AF) is associated with a significantly increased stroke risk which is highly preventable with appropriate oral anticoagulant therapy (OAC). However, AF may be asymptomatic and unrecognised prior to stroke. We aimed to determine if single time-point screening for AF could identify sufficient numbers with previously undiagnosed AF, to be effective for stroke prevention. This is a systematic review of clinical trials, by searching electronic medical databases, reference lists and grey literature. Studies were included if they evaluated a general ambulant adult population, using electrocardiography or pulse palpation to identify AF. We identified 30 individual studies (n=122,571, mean age 64 years, 54% male) in nine countries. Participants were recruited either from general practitioner and outpatient clinics (12 studies) or population screening/community advertisements (18 studies). Prevalence of AF across all studies was 2.3% (95% CI, 2.2–2.4%), increasing to 4.4% (CI, 4.1–4.6%) in those ≥65 years (16 studies, n= 27,884). Overall incidence of previously unknown AF (14 studies, n=67,772) was 1.0% (CI, 0.89–1.04%), increasing to 1.4% (CI, 1.2–1.6%) in those ≥65 years (8 studies, n= 18,189) in whom screening setting did not influence incidence identified. Of those with previously unknown AF, 67% were at high risk of stroke. Screening can identify 1.4% of the population ≥65 years with previously undiagnosed AF. Many of those identified would be eligible for, and benefit from OAC to prevent stroke. Given this incidence, community AF screening strategies in at risk older age groups could potentially reduce the overall health burden associated with AF.

Education of Self-Radial Pulse Palpation and Atrial Fibrillation Signs and Symptoms

2021 ◽  
Vol 38 (3) ◽  
pp. 193-199
Author(s):  
Cara M Voelliger ◽  
Kathryn J VanderZwan ◽  
Edmund P Coyne ◽  
Yuhning Hu ◽  
Nicolas W Shammas ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Signs And Symptoms ◽  
Radial Pulse ◽  
Pulse Palpation

Routine podiatry assessment as a potential preventive tool for atrial fibrillation screening in diabetics

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
M Petridou ◽  
E Matopoulou ◽  
I Kanellos ◽  
S Daios ◽  
I Patrikios ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Early Detection ◽  
Health Professionals ◽  
Allied Health ◽  
Allied Health Professionals ◽  
Stroke Incidence ◽  
Non Invasive ◽  
Arterial Blood ◽  
Pulse Palpation ◽  
Significant Difference

Abstract Funding Acknowledgements Type of funding sources: None. Background/Introduction Atrial fibrillation (AF) is a common heart arrhythmia predominantly in advanced age patients and in diabetic’s type II (DMPII). Even if the risk of stroke in AF in DMPII is relative high, 25% of AF patients remains undiagnosed and also cryptogenic AF is very common in the diabetic population. During a 12-month study project, podiatrists and podologists performed foot pulse-checks in their routine podiatry assessment, when encountering visual symptoms that suggest an underlying circulatory disorder in diabetics. This simple non-invasive method aims to increase screening and diagnosis of AF from allied health professionals, in order to reveal patients with previously undiagnosed AF and patients with cryptogenic Af, challenging the potential reduction of AF complications and mainly of stroke. Purpose  Early detection of AF in diabetics from allied health professionals during routine podiatry assessment. Revealing of previously undiagnosed AF contributes to stroke and other AF complications incidence reduction in the diabetics population. Methods  During a 12-month study, 2 podiatrists and 6 podologists performed foot pulse-checks on diabetics, during their annual foot screening appointments, since they have been trained from medical doctors to spot rhythm abnormalities during pulse palpation of the foot arteries. They have been also trained to confirm their pulse palpation evidence thought Doppler ultrasound wave assessments during evaluation of arterial blood supply (anterior-posterior tibial arteries and ramifications) of the diabetic foot. During the study 300 diabetics (mean age 60 years old, 180 males, 120 females) had their feet pulse-tested. Spss statistical software had been used.  Results  17% of diabetics during foot pulse-checks presents undiagnosed AF. There was no statistically significant difference (p < 0.05) between sex  (males and females AF screening percents were similar).  Conclusion(s)  Early detection and properly managed during AF screening reduces AF complications and specifically stroke incidence. Opportunistic podiatric detection of previously undiagnosed and cryptogenic AF from allied professionals is a non invasive, safe, fast and economic method with potential contributions in this direction. More studies must be designed in order to support the routine podiatry assessment, as a useful Screening diagnostic tool of AF for reducing cardiovascular complications incidence in diabetics but also in the general population.

Silent atrial fibrillation

ESC CardioMed ◽  
2018 ◽  
pp. 2132-2135
Author(s):  
Ben Freedman ◽  
Nicole Lowres
Keyword(s):  
Atrial Fibrillation ◽  
Cost Effective ◽  
Ventricular Rate ◽  
Pulse Palpation ◽  
Activity Management ◽  
Routine Clinical Examination ◽  
Electrocardiogram Ecg ◽  
Tachycardia Induced Cardiomyopathy ◽  
Implanted Device ◽  
Single Time Point

Silent or asymptomatic atrial fibrillation (AF) is common. It can occur in patients with symptomatic AF, where silent episodes often outweigh symptomatic episodes. It can also occur in patients who experience no symptoms at all, or who have non-specific AF symptoms. Silent AF may present with a stroke (approximately 9% of all ischaemic strokes) or with heart failure due to tachycardia-induced cardiomyopathy which responds to control of ventricular rate. Silent AF is often found during routine clinical examination by pulse palpation or routine electrocardiogram (ECG), or with implanted cardiac electronic devices which continuously sense atrial activity. Management of implanted device-detected AF is debated as the stroke risk is lower than symptomatic AF, particularly when episodes are brief. Silent AF may be detected by opportunistic screening, either at a single time point or by multiple patient-initiated recordings over 2 weeks. AF screening may utilize pulse palpation, photoplethysmography, modified sphygmomanometers, or handheld ECG devices. Because an ECG is required for a diagnosis, handheld ECG recorders with automated AF detection are now recommended. Screen-detected AF is not low risk and requires antithrombotic therapy. Screening for AF to prevent stroke has been shown to be cost-effective.

scholarly journals Pharmacists detecting atrial fibrillation (PDAF) in primary care during the influenza vaccination season: a multisite, cross-sectional screening protocol

BMJ Open ◽  
2018 ◽  
Vol 8 (3) ◽  
pp. e021121 ◽  
Author(s):  
Emma L Veale ◽  
Adrian J Stewart ◽  
Alistair Mathie ◽  
Satvinder K Lall ◽  
Melanie Rees-Roberts ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Influenza Vaccination ◽  
Demographic Data ◽  
Cardiovascular Complications ◽  
Cross Sectional ◽  
Clinical Pharmacists ◽  
Pulse Palpation ◽  
Increased Risk ◽  
General Practices ◽  
Level Of Agreement

IntroductionAtrial fibrillation (AF) affects >6% of people aged 65 years or older. Left undetected and untreated, patients may develop significant cardiovascular complications and have a fivefold increased risk of suffering a stroke. For 40% of all sufferers, AF can be asymptomatic. Every year in the UK, £2.2 billion is spent on AF-related strokes, so there is an urgent need to improve early detection of AF. This study aims to determine the feasibility of using trained clinical pharmacists based in general practices, to screen for AF, using pulse palpation and a single-lead ECG device on participants aged 65 years or older, attending influenza vaccination clinics.Methods and analysisSeven clinical pharmacists will be trained by a cardiologist to pulse palpate and record single-lead ECGs using the AliveCor Kardia Mobile device. Quantitative analysis will assess the accuracy and ability of the clinical pharmacist to identify pulse irregularities using pulse palpation and to record and interpret a single-lead ECG. The level of agreement of pulse irregularities detected by pulse palpation will be compared with those detected by the single-lead ECG device, as will the level of agreement between the cardiologist and the device’s interpretation of the ECG. The proportion of people identified with AF (confirmed by the cardiologist) will be determined. Additional demographic data will be obtained from all participants through a questionnaire. Qualitative data will be captured from the participants, from the clinical pharmacists and from the general practitioners and practice staff to determine their views on this method of AF screening. We aim to recruit 600 participants across general practices within Kent.Ethics and disseminationThis protocol was approved by the London–Riverside Research Ethics committee. The findings of this study will be disseminated through forums including, but not limited to, peer-reviewed journals, national and international conferences.

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