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Handheld Device Used to Screen for A-Fib in Primary Care Setting

Single-lead ECG device did not increase new diagnoses of atrial fibrillation for those aged 65 years or older compared with usual care

THURSDAY, March 24, 2022 (HealthDay News) — A handheld single-lead electrocardiogram (ECG) device used for screening of older adults at primary care visits does not increase new diagnoses of atrial fibrillation (AF) in a population aged 65 years or older, according to a study published online March 2 in Circulation.

Steven A. Lubitz, M.D., M.P.H., from Massachusetts General Hospital in Boston, and colleagues randomly assigned 16 primary care clinics to AF screening using a handheld single-lead ECG during vital sign assessments or usual care in a 1:1 ratio. A total of 30,715 patients without prevalent AF, all aged 65 years or older, were included (15,393 screening and 15,322 control).

The researchers found that 1.72 and 1.59 percent of individuals in the screening group and the control group, respectively, had new AF diagnosed at one year (risk difference [RD], 0.13 percent; 95 percent confidence interval [CI], −0.16 to 0.42; P = 0.38). In prespecified subgroup analyses, among those aged 85 years or older, new AF diagnoses were greater in the screening and control groups (RD, 1.80 percent; 95 percent CI, 0.18 to 3.30). A greater difference in newly diagnosed AF between the screening period and the prior year in the screening group versus control group was observed in patients 85 years and older.

“We think handheld devices are best deployed for people at the highest risk of a-fib and stroke, and age is an excellent surrogate for that determination,” Lubitz said in a statement.

Several authors disclosed financial ties to pharmaceutical and medical device companies, including Bristol Myers Squibb/Pfizer, which funded the study.

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