Wearable dynamic electrocardiogram monitor-based screening for atrial fibrillation in the community-dwelling elderly population

Abstract

Background: Atrial fibrillation (AF) is a major public health problem with high rates of morbidity, disability and mortality, especially in the elderly population. This study explored the diagnosis and treatment status of AF in adults aged ≥65 years in the community through wearable dynamic electrocardiogram (ECG) monitoring. Methods: We conducted a cross-sectional study in 4 random communities within the Qingpu district of Shanghai, China. Between January 1, 2020 and June 30, 2022, the ECGs of 3852 adults aged 65 years or older were examined through wearable dynamic ECG monitoring. Data from 3839 participants were ultimately analyzed. Multivariate logistic regression was used to determine the independent predictors of AF. Results: Wearable dynamic ECG monitoring detected AF in 360 elderly people, 78 of whom were diagnosed with AF for the first time. Multivariate logistic regression analysis revealed that snoring, renal dysfunction, coronary heart disease and high CHA2DS2-VASc score were independent risk factors for AF. Among patients with unknown AF, 68 (87.20 %) met the criteria for anticoagulant therapy based on the CHA2DS2-VASc score. Only 4 (5.88 %) patients were taking anticoagulants. Of the patients with a clear history of AF, 249 (84.98 %) needed an anticoagulant strategy, but only 18 (7.23 %) took oral anticoagulants. Conclusion: Many elderly people have silent AF, and wearable dynamic ECG monitoring can be used to screen for AF effectively.

Keywords

• Atrial fibrillation
• Electrocardiogram
• Anticoagulant therapy
• Ischemic stroke
• Elderly population