Zhongguo quanke yixue (Apr 2024)
Analysis of the Effectiveness of Different Atrial Fibrillation Screening Methods in the Community-based Elderly Population
Abstract
Background Older adults are at high risk for atrial fibrillation (AF). Improving the efficiency of AF screening among the community-based elderly population can help to reduce the risk of AF-related stroke. Objective To compare the screening efficiency of different AF screening methods in the elderly population. Methods A total of 1 300 cases of older adults were selected from three neighborhood committees of Xiangshan, Huangshan, and Luoshan in Jinyang Community, Pudong New Area, Shanghai from July 2022 to January 2023. AF screening was detected using palpation of radial artery pulse, electronic sphygmomanometer with AF detection function, and single-lead ECG recorder. A positive result of any one of the three methods was considered positive for AF, and finally an electrocardiogram (ECG) was performed and interpreted by a physician in the ECG room. The receiver operating characteristic (ROC) curves of the subjects with different screening methods were plotted, the area under the ROC curve (AUC) was calculated to evaluate the screening value; the association between AF stroke score (CHA2DS2-VASc score) and AF was analyzed using the chi-square test for trend. Results AF was detected in 93 of the 1 300 people, including 57 asymptomatic people; 375 people had a positive palpated pulse, 331 people had a positive electronic blood pressure monitor with AF detection function, and 128 people had a positive result of single-lead ECG recorder. The AUCs for the diagnostic value of palpation pulse, electronic sphygmomanometer with AF detection function and single-lead ECG recorder in the elderly was 0.750 (95%CI=0.697-0.803, P<0.01), 0.832 (95%CI=0.790-0.874, P<0.01), 0.939 (95%CI=0.906-0.973, P<0.01) ; the incidence of AF in the elderly gradually increased as the CHA2DS2-VASc score increased (χ2trend=197.46, P<0.01) . Conclusion Screening for AF using single-lead ECG recorder is convenient, efficient and accurate, and can be promoted in AF screening among community-based elderly population.
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