Key result
Microlife WatchBP Home A detects AF with high diagnostic accuracy in primary care.
Why the study?
Does the Microlife WatchBP Home A device accurately detect atrial fibrillation compared to lead-I ECG in primary care patients?
Cross-Sectional (n=5,969)
No
Does the Microlife WatchBP Home A device accurately detect atrial fibrillation compared to lead-I ECG in primary care patients?
The Microlife WatchBP Home A device provides an effective and accurate method for opportunistic atrial fibrillation screening during routine blood pressure measurement in primary care.
Answers are grounded in this paper and cite their sources.
May aid opportunistic AF screening during primary care BP measurement; hypothesis-generating pending randomized outcome trials.
OBJECTIVE: To evaluate the diagnostic performance of a UK National Institute for Health and Care Excellence-recommended automatic oscillometric blood pressure (BP) measurement device incorporated with an atrial fibrillation (AF) detection algorithm (Microlife WatchBP Home A) for real-world AF screening in a primary healthcare setting. SETTING: Primary healthcare setting in Hong Kong. INTERVENTIONS: This was a prospective AF screening study carried out between 1 September 2014 and 14 January 2015. The Microlife device was evaluated for AF detection and compared with a reference standard of lead-I ECG. PRIMARY OUTCOME MEASURES: Diagnostic performance of Microlife for AF detection. RESULTS: : sex category [female] [1 point])score was 2.8±1.3. AF was diagnosed in 72 patients (1.21%) and confirmed by a 12-lead ECG. The Microlife device correctly identified AF in 58 patients and produced 79 false-positives. The corresponding sensitivity and specificity for AF detection were 80.6% (95% CI 69.5 to 88.9) and 98.7% (95% CI 98.3 to 98.9), respectively. Among patients with a false-positive by the Microlife device, 30.4% had sinus rhythm, 35.4% had sinus arrhythmia and 29.1% exhibited premature atrial complexes. With the low prevalence of AF in this population, the positive and negative predictive values of Microlife device for AF detection were 42.4% (95% CI 34.0 to 51.2) and 99.8% (95% CI 99.6 to 99.9), respectively. The overall diagnostic performance of Microlife device to detect AF as determined by area under the curves was 0.90 (95% CI 0.89 to 0.90). CONCLUSIONS: In the primary care setting, Microlife WatchBP Home was an effective means to screen for AF, with a reasonable sensitivity of 80.6% and a high negative predictive value of 99.8%, in addition to its routine function of BP measurement. In a younger patient population aged <65 years with a lower prevalence of AF, Microlife WatchBP Home A demonstrated a similar diagnostic accuracy.
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Chan et al. (2017) conducted a cross-sectional in Atrial Fibrillation (n=5,969). Microlife WatchBP Home A vs. Single-lead-I ECG was evaluated on Diagnostic performance for AF detection (Area under the curve) (AUC 0.90, 95% CI 0.89-0.90). The Microlife WatchBP Home A device effectively detected atrial fibrillation in a primary care setting, demonstrating an AUC of 0.90 with a sensitivity of 80.6% and specificity of 98.7%.
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