Key result
Atrial fibrillation did not significantly alter ankle-brachial index values measured by the automated oscillometric method compared to sinus rhythm (1.21 vs 1.22, p=0.664), though the method showed poor agreement with Doppler measurements.
Why the study?
Oscillometric devices are effective for measuring the ankle-brachial index, but their accuracy during atrial fibrillation is unknown.
Does the automated oscillometric method provide accurate ankle-brachial index (ABI) measurements compared to the reference Doppler method in patients with atrial fibrillation?
Observational (n=99)
No
Does the automated oscillometric method provide accurate ankle-brachial index (ABI) measurements compared to the reference Doppler method in patients with atrial fibrillation?
The automated oscillometric method for ABI measurement overestimates values and shows poor agreement with the reference Doppler method in patients with atrial fibrillation, indicating it should not replace Doppler in this population.
Answers are grounded in this paper and cite their sources.
Oscillometric ABI lacks agreement with Doppler during AF; should not replace reference method pending validation in PAD.
Introduction Repeated measurements of ankle-brachial index (ABI) using Doppler method were shown to be accurate during atrial fibrillation. Oscillometric devices are effective in ABI measurement, but their accuracy during atrial fibrillation is unknown. The purpose of the study was to investigate whether atrial fibrillation influences ABI obtained with the automatic oscillometric method. Material and methods Ninety-nine patients with atrial fibrillation (mean age: 66.6 +(SD = 11) years, M/F 63/36) who underwent electrical cardioversion were investigated (198 lower extremities). The ABI measurements using oscillometric and Doppler methods were performed on both lower extremities before and after procedure. Results The ABI measured using the oscillometric method on both lower limbs did not change after cardioversion (1.21 (IQR: 1.13-1.27) vs. 1.22 (IQR: 1.14-1.26), p = 0.664, respectively). The ABI measured before and after cardioversion using Doppler and oscillometric methods showed a significant difference (1.14 (IQR: 1.07-1.22) vs. 1.21 (IQR 1.13-1.27), p < 0.001 and 1.18 (IQR: 1.09-1.13) vs. 1.22 (IQR: 1.14-1.26), p < 0.001 respectively). Both methods showed a weak correlation before (r = 0.35, p < 0.001) and no correlation after cardioversion (r = 0.12, p = 0.07). The Bland-Altman plot showed poor agreement between measurements performed with the Doppler and oscillometric methods in sinus rhythm and during atrial fibrillation. Conclusions The automated oscillometric method of ABI measurements should not replace the reference Doppler method in patients with atrial fibrillation. More research related to the oscillometric measurements is needed in subjects with peripheral artery disease and atrial fibrillation.
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Dąbrowski et al. (2019) conducted an observational in Atrial fibrillation (n=99). Atrial fibrillation vs. Sinus rhythm (post-cardioversion) was evaluated on Difference between ABI measures before and after electrical cardioversion using the oscillometric method (p=0.664). Atrial fibrillation did not significantly alter ankle-brachial index values measured by the automated oscillometric method compared to sinus rhythm (1.21 vs 1.22, p=0.664), though the method showed poor agreement with Doppler measurements.
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