scholarly journals Accuracy of Physicians Interpreting Photoplethysmography and Electrocardiography Tracings to Detect Atrial Fibrillation: INTERPRET-AF

2021 ◽  
Vol 8 ◽  
Author(s):  
Henri Gruwez ◽  
Stijn Evens ◽  
Tine Proesmans ◽  
David Duncker ◽  
Dominik Linz ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Diagnostic Accuracy ◽  
Online Survey ◽  
Poincaré Plot ◽  
Incremental Value ◽  
Significant Difference ◽  
Increased Sensitivity ◽  
Ectopic Beats

Aims: This study aims to compare the performance of physicians to detect atrial fibrillation (AF) based on photoplethysmography (PPG), single-lead ECG and 12-lead ECG, and to explore the incremental value of PPG presentation as a tachogram and Poincaré plot, and of algorithm classification for interpretation by physicians.Methods and Results: Email invitations to participate in an online survey were distributed among physicians to analyse almost simultaneously recorded PPG, single-lead ECG and 12-lead ECG traces from 30 patients (10 in sinus rhythm (SR), 10 in SR with ectopic beats and 10 in AF). The task was to classify the readings as ‘SR', ‘ectopic/missed beats', ‘AF', ‘flutter' or ‘unreadable'. Sixty-five physicians detected or excluded AF based on the raw PPG waveforms with 88.8% sensitivity and 86.3% specificity. Additional presentation of the tachogram plus Poincaré plot significantly increased sensitivity and specificity to 95.5% (P < 0.001) and 92.5% (P < 0.001), respectively. The algorithm information did not further increase the accuracy to detect AF (sensitivity 97.5%, P = 0.556; specificity 95.0%, P = 0.182). Physicians detected AF on single-lead ECG tracings with 91.2% sensitivity and 93.9% specificity. Diagnostic accuracy was also not optimal on full 12-lead ECGs (93.9 and 98.6%, respectively). Notably, there was no significant difference between the performance of PPG waveform plus tachogram and Poincaré, compared to a single-lead ECG to detect or exclude AF (sensitivity P = 0.672; specificity P = 0.536).Conclusion: Physicians can detect AF on a PPG output with equivalent accuracy compared to single-lead ECG, if the PPG waveforms are presented together with a tachogram and Poincaré plot and the quality of the recordings is high.

scholarly journals Vernakalant for cardioversion of recent-onset atrial fibrillation: a systematic review and meta-analysis

EP Europace ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. 1159-1166 ◽  
Author(s):  
William F McIntyre ◽  
Jeff S Healey ◽  
Akash K Bhatnagar ◽  
Patrick Wang ◽  
Jacob A Gordon ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Meta Analysis ◽  
Structural Heart Disease ◽  
Quality Of Evidence ◽  
Recent Onset ◽  
Assessment Development ◽  
Significant Difference ◽  
Pharmacological Cardioversion

AbstractAimsTo evaluate the efficacy and safety of vernakalant for the cardioversion of atrial fibrillation (AF).Methods and resultsWe reviewed the literature for randomized trials that compared vernakalant to another drug or placebo in patients with AF of onset ≤7 days. We used a random-effects model to combine quantitative data and rated the quality of evidence using the GRADE (Grades of Recommendation, Assessment, Development and Evaluation). From 441 total citations in MEDLINE, EMBASE, and CENTRAL (December 2018), we identified nine trials evaluating 1358 participants. Six trials compared vernakalant to placebo, two trials compared vernakalant to ibutilide, and one trial compared vernakalant to amiodarone. We found significant methodological bias in four trials. For conversion within 90 min, vernakalant was superior to placebo [50% conversion, risk ratio (RR) 5.15; 95% confidence interval (CI); 2.24–11.84, I2 = 91%], whereas we found no significant difference in conversion when vernakalant was compared with an active drug (56% vs. 24% conversion, RR 2.40; 95% CI 0.76–7.58, I2 = 94). Sinus rhythm was maintained at 24 h in 85% (95% CI 80–88%) of patients who converted acutely with vernakalant. Overall, we judged the quality of evidence for efficacy to be low based on inconsistency and suspected publication bias. There was no significant difference in the risk of significant adverse events between vernakalant and comparator (RR 0.95; 95% CI 0.70–1.28, I2 = 0, moderate quality evidence). Vernakalant is safe and effective for rapid and durable restoration of sinus rhythm in patients with recent-onset AF.ConclusionVernakalant should be a first line option for the pharmacological cardioversion of patients with haemodynamically stable recent-onset AF without severe structural heart disease.

scholarly journals Diabetes knowledge, risk perception, and quality of life among South Asian caregivers in young adulthood

2020 ◽  
Vol 8 (2) ◽  
pp. e001268
Author(s):  
Angela Koipuram ◽  
Sandra Carroll ◽  
Zubin Punthakee ◽  
Diana Sherifali
Keyword(s):  
Quality Of Life ◽  
Risk Perception ◽  
South Asian ◽  
Online Survey ◽  
Educational Interventions ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Significant Difference ◽  
Design And Methods

IntroductionPersons of South Asian descent have a higher prevalence of type 2 diabetes mellitus (T2DM). The management of T2DM in the South Asian community has required the support of adult children, potentially impacting the quality of life, diabetes-related knowledge, and risk perception among these caregivers.Research design and methodsTo investigate diabetes-related knowledge, quality of life, risk perception, and actual risk of developing diabetes among South Asian young adults whose parents are living with T2DM. A cross-sectional study was conducted (n=150). An online survey was administered. Data were analyzed with descriptive and inferential statistics.ResultsThere was a statistically significant difference in diabetes-related knowledge between males and females (p<0.001). Males (in comparison to females) had a lower risk perception of developing diabetes (p=0.06). Further, risk perception and diabetes-related knowledge were positively associated with caregiver’s physical health (p=0.002).ConclusionFindings highlight the importance of providing gender-specific and culturally tailored diabetes educational interventions.

scholarly journals Comparison of modified MAZE with minimally invasive monopolar ablation and traditional bipolar radiofrequency ablation in the treatment of atrial fibrillation

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Wei Si ◽  
Sijia Yang ◽  
Linhui Pan ◽  
Chengchegn Li ◽  
Liang Ma
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Radiofrequency Ablation ◽  
Minimally Invasive ◽  
Sinus Rhythm ◽  
Ablation Rate ◽  
Atrial Fibrillation Ablation ◽  
Bipolar Radiofrequency ◽  
Postoperative Quality

Abstract Background and aim of the study Atrial fibrillation (AF) is the most common atrial arrhythmia. Our aim was to compare the outcomes of atrial fibrillation treatment with original modified minimally invasive MAZE using monopolar radiofrequency ablation (mi-MAZE) and open surgery MAZE using bipolar radiofrequency ablation (os-MAZE). Methods We searched the associated patients’ information on the medical record system of the First Affiliated Hospital, School of Medicine, Zhejiang University. Statistical Package for Social Sciences (SPSS) was used to analyse the data. The primary outcome is the atrial fibrillation ablation rate 3 months, 6 months, 12 months after operation. And secondary outcome is the postoperative quality of life. Results The mi-MAZE group included 42 patients and the os-MAZE group had 65 patients. Three months after surgery, we found that 31 patients (77.5%) in the mi-MAZE group were sinus rhythm and 44 (71.0%) recovered sinus rhythm in the os-MAZE group. We followed up these patients on the phone or in person and scored them on the SF-36 scale. The results were found to be 120.2 ± 8.10 vs 110.6 ± 6.58 (mi-MAZE vs os-MAZE, P < 0.001). Conclusions There was no significant difference of atrial fibrillation ablation rate (sinus rhythm recovery rate) between the mi-MAZE group and the os-MAZE group. The postoperative quality of life in mi-MAZE group was higher than that in os-MAZE group.

scholarly journals Work Productivity Loss in Inflammatory Bowel Disease Patients in Turkey

2020 ◽  
Vol 2020 ◽  
pp. 1-6 ◽  
Author(s):  
Firdevs Topal ◽  
Hakan Camyar ◽  
Elif Saritas Yuksel ◽  
Suleyman Gunay ◽  
Fatih Topal ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Online Survey ◽  
Productivity Loss ◽  
Young Patients ◽  
Significant Difference ◽  
Inflammatory Bowel ◽  
The Impact

Background. Beyond the medical treatment in inflammatory bowel disease (IBD), there are other issues which influence the quality of life adversely. The aim of this study was to determine the impact of the IBD patients’ illness on working and education life. Method. The participants were invited to participate in the online survey from the Turkish Crohn’s and Ulcerative Colitis Patient Association network. The data was analysed and then discussed to improve the health-related quality of working and education life. Results. One hundred and fifteen patients had ulcerative colitis (UC) (57.2%), and 86 had Crohn’s disease (CD) (42.8%). There was a statistically significant difference in UC between retirement age group 1 (<40 age) and groups 2 (40-49 ages) and 4 (60-65 ages) (p<0.05). There was the same significant difference in CD. Even though the data did not have significant statistical difference, there was clustering around negative perceptions the patients have about their working and education lives. Conclusion. Our survey revealed a very strong causative relationship between work and IBD involving problems before, during, and at the end of employment. Young patients lower their career expectations, and that announces a clear need to support them and improve career guidance.

Quality of Life Experiences among Women with Atrial Fibrillation: Findings from an Online Survey

2016 ◽  
Vol 26 (3) ◽  
pp. 288-297 ◽  
Author(s):  
Everly Macario ◽  
Yukari T. Schneider ◽  
Susan M. Campbell ◽  
Annabelle Santos Volgman
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Online Survey ◽  
Life Experiences

scholarly journals Atrial fibrillation recurrence after transcatheter ablation worsens left atrial strain

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Annunziata ◽  
F Notaristefano ◽  
L Spighi ◽  
S Piraccini ◽  
G Giuffre' ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Left Atrial ◽  
Left Atrial Strain ◽  
Systolic Volume ◽  
End Systolic Volume ◽  
Atrial Strain ◽  
Af Recurrence

Abstract Introduction Left atrial strain (LAs) shows correlation with atrial fibrosis and is a predictor of atrial fibrillation (AF) recurrence after transcatheter ablation. Little is known about LAs evolution after ablation. Purpose We sought to evaluate the atrial function with echocardiographic strain before and 6 months after AF ablation. Methods 65 consecutive patients undergoing radiofrequency or cryoballoon ablation for atrial fibrillation at our centre were enrolled. They underwent a transthoracic echocardiography before the procedure and at 6 months follow-up. 5 patients were excluded because of low quality images. Global left atrial strain during the reservoir phase (LASr) was calculated as a mean of the values obtained in 4 and 2 chamber apical view; the ventricular end-diastole was set as reference to allow the calculation both in patients in AF and sinus rhythm during the echocardiography. Recurrence was defined as any atrial arrhythmia episode lasting more than 30 seconds recorded on an EKG strip after the 3 months blanking period; all patients underwent a 24 hours EKG Holter after the blanking period to detect asymptomatic recurrence. Quality of life was assessed before the procedure and at follow-up with the EQ-5D-3L model. Results At 6 months 14 patients (13%) had AF recurrence. Patients with recurrence (AF-R) had similar baseline characteristics compared to those without recurrence (AF-NR) but the former had a longer history of AF (39±53 vs 85±94 months, p=0,018). LASr, LA volume and left ventricle ejection fraction (EF) were similar at baseline between groups. At follow-up LASr was significantly impaired in the AF-R group compared to AF-NR (14±6% vs 26±10% respectively, p&lt;0,0001) whereas LA volume, LV end systolic volume and EF remained similar. Compared to baseline LASr worsened in patients experiencing AF recurrence (22±11% vs 14±6%, p=0.016) and this finding was consistent also in patients in sinus rhythm during both examinations (29±8 vs 17±7, p=0,005). Compared to baseline LASr (22±10% vs 26±10%, p=0.024), LV end-systolic volume (29±15 ml vs 22±6 ml, p=0,006) and EF (51±9% vs 58±18%, p=0,038) improved in the AF-NR group but the effect was driven mainly by patients restoring sinus rhythm. Both groups showed a significant improvement of the quality of life (55±23 vs 85±13, p&lt;0,0001 AF-NR; 63±17 vs 80±12, p=0,012 AF-R). Conclusions Atrial fibrillation recurrence after transcatheter ablation is associated with significant left atrial strain worsening which indicates disease progression and may predispose to further long-term recurrences whereas a successful ablation has a protective effect on atrial function. Funding Acknowledgement Type of funding source: None

scholarly journals Diagnostic performance of a wearing dynamic ECG recorder for Atrial Fibrillation screening: The HUAMI heart study

2021 ◽  
Author(s):  
Fu Wenxia ◽  
Li Ruogu
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Normal Sinus Rhythm ◽  
False Negative ◽  
Upright Position ◽  
Normal Sinus ◽  
Heart Study ◽  
User Friendly

Abstract Background: Atrial fibrillation (AF) is the most prevalent cardiac dysrhythmia with a significant morbidity and mortality rate. Notably, one out of three patients with AF is asymptomatic. Given the asymptomatic and paroxysmal nature of AF, AF's timely detection with traditional instruments is somewhat unsatisfactory and delayed. Thus, wearing a dynamic electrocardiogram (ECG) recorder can help analyze, interpret, and distinguish AF from normal sinus rhythm accurately and safely, even in an upright position and after exercises, using an artificial intelligence (AI) algorithm.Methods: A total of 114 participants in the outpatient registry of our institution from June 24, 2020 to July 24, 2020, were enrolled. Participants were tested with a wearable dynamic ECG recorder and 12-lead ECG in a supine, an upright position and after exercises for 60seconds. Results: A total of 114 subjects (sixty-one with normal sinus rhythm, fifty-three with AF) were enrolled in the study. The number of cases unable to be determined by the dynamic ECG recorder wristband was two, one in each group. Case results not clinically objective were defined as false-negative or false-positive. The diagnostic accuracy, sensitivity and specificity using wearable dynamic ECG recorders in a supine position were 94.74% (95% CI% 88.76%-97.80%), 88.68% (95% CI 77.06%-95.07%) and100% (95% CI 92.91%-100%), respectively. Meanwhile, the diagnostic accuracy, sensitivity and specificity in an upright position were 97.37% (95% CI% 92.21%-99.44%), 94.34% (95% CI 84.03%-98.65%), and 100% (95% CI 92.91%-100%), respectively. The result after exercise was the same as the result of the upright position.Conclusion: AF can be detected using the widely accessible wearable dynamic ECG recorder with an AI algorithm after different postures and exercises. It may provide a useful and user-friendly screening tool, diagnosing AF early in at-risk individuals.

scholarly journals Time in Therapeutic Range, Quality of Life and Treatment Satisfaction of Patients on Long-Term Warfarin for Non-Valvular Atrial Fibrillation: A Cross-Sectional Study

2020 ◽  
Author(s):  
Diana-Leh-Ching Ng ◽  
Natasya Marliana Bt Abdul Malik ◽  
Chee-Shee Chai ◽  
Greta-Miranda-Kim-Choo Goh ◽  
Seng-Beng Tan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Atrial Fibrillation ◽  
Therapeutic Range ◽  
Treatment Satisfaction ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Significant Difference

Abstract Background:The use of warfarin in patients with non-valvular atrial fibrillation (NVAF) can be challenging. In this study, we evaluate the time in therapeutic range (TTR), health-related quality of life (HRQoL) and treatment satisfaction of patients on long-term warfarin for NVAF. The HRQoL and treatment satisfaction were compared based on the TTR.Methods:A cross-sectional study was conducted among patients on warfarin for NVAF who attended the anticoagulant clinic of a tertiary cardiology referral center in Sarawak from 1st June 2018 to 31st May 2019. Patients’ TTR was calculated by using Rosendaal technique, while their HRQoL and treatment satisfaction were assessed by using Short Form 12 Health Survey version 2 (SF12v2) and Duke Anticoagulant Satisfaction Scale (DASS), respectively. Results: A total of 300 patients were included, with mean TTR score of 47.0 ± 17.3%. The physical component summary (PCS) and mental component summary (MCS) score of SF-12v2 were 47.0 ± 9.0 and 53.5 ± 9.6, respectively. The total score for DASS was 55.2 ± 21.3, while the score for limitations (L), hassles and burdens (H&B) and positive psychological impacts (PPI) were 18.0 ± 10.0, 15.6 ± 9.1 and 21.6 ± 5.9, respectively. Seventy-three (24.3%) patients had good TTR (≥ 60%), with mean of 70.2 ± 8.7%; while 227 (75.5%) patients with poor TTR had significantly lower mean of 39.5 ± 11.9% (p = 0.006). There was no significant difference in the score of PCS (p = 0.150), MCS (p = 0.919) and each domain of SF-12v2 (p = 0.184 – 0.684) between good and poor TTR, except for social functioning (p = 0.019). The total DASS score was also not significantly different between group (p = 0.779). Similar non-significant difference was also reported in all the DASS sub dimensions (p = 0.502 – 0.699).Conclusions:Majority of the patients on long-term warfarin for NVAF in the current study have poor TTR. Their HRQoL and treatment satisfaction are independent of their TTR. Achieving a good TTR do not compromise the HRQoL and treatment satisfaction. Therefore, appropriate measures should be taken to optimise INR control, failing which direct oral anticoagulant therapy should be considered.

P6597Long-term impact of catheter ablation on growth differentiation factor-15 and neutrophil-lymphocyte ratio in paroxysmal atrial fibrillation

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Bin Waleed ◽  
Y L Xia ◽  
L J Gao ◽  
Y Xiaomeng ◽  
G Tse ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Catheter Ablation ◽  
Sinus Rhythm ◽  
Inflammatory Biomarkers ◽  
Growth Differentiation Factor 15 ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Differentiation Factor ◽  
Significant Difference

Abstract Background There is increasing evidence that inflammatory biomarkers growth differentiation factor 15 (GDF-15) and neutrophil-lymphocyte ratio (NLR) appear to be associated with stroke and adverse cardiovascular events in patients with atrial fibrillation (AF). However, long-term impact of catheter ablation (CA) on GDF-15 and NLR is still unknown. Objective To evaluate the long-term change in GDF-15 and NLR after CA in paroxysmal AF patients. Methods A total of 58 paroxysmal AF patients were consecutively enrolled to perform CA. The inflammatory biomarkers GDF-15 and NLR were measured at baseline and 6-months postablation. Results All patients except one could complete 6-Months follow up. Fifty (87.7%) patients maintained sinus rhythm (SR group) and seven (12.3%) patients sustained AF recurrence (AFR group). No significant difference was noted in clinical and procedural characteristics between two groups (p>0.05), except mean fluoroscopy time (minutes 22±11.7 vs. 13±5.3, p=0.001) significantly longer in AFR than SR group. The GDF-15 (pg/ml 195±57 vs. 216±88, p=0.398), and NLR (% 1.8 (1.3–3) vs. 2.6 (1.4–3.4), p=0.395) were comparable at baseline in both SR and AFR groups respectively. At 6-months postablation, GDF-15 (pg/ml 133±41 vs. 195±57, p<0.001), and NLR (% 1.6 (1.1–2) vs. 1.8 (1.3–3), p=0.004) were significant deceased compared to baseline levels in SR group. However, GDF-15 (pg/ml 139±86 vs. 216±88, p=0.064), and NLR (% 1.6 (1.2–3) vs. 2.6 (1.4–3.4), p=0.398) biomarkers remained comparable to baseline level in AFR group (p>0.05) Conclusion Inflammatory biomarkers; GDF-15 and NLR significantly decreased at long-term on successful maintenance of sinus rhythm by CA in paroxysmal AF patients. Acknowledgement/Funding None

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