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Validation of a simple method for atrial fibrillation screening in patients with stroke

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Abstract

Atrial fibrillation (AF) is the most common cardiac arrhythmia in adult and old people and represents a risk factor for stroke. Correct AF individuation bears strong relevance in primary and secondary stroke prevention. Our goal was to evaluate the reliability of a low-cost, non-invasive technology in detecting AF in acute stroke patients. AFib model BP3MQ1-2D (Microlife USA, Dunedin, FL) showed good accuracy in diagnosing AF in a general cardiologic outpatient population. We carried out an observational study in patients with recent stroke. We studied 207 subjects, 103 men, 104 women, mean age (±SD) 77.7 ± 11.34 years, who underwent a test by AFib device with indication of AF or lack of it. The golden standard was a 12-lead EKG done immediately and evaluated by a certified cardiologist. We computed estimates of Sensitivity and Specificity and their 95 % confidence intervals (CI). AF was present in 38 subjects from the sample of 207 (18.4 %). AFib correctly demonstrated AF in 34 and failed diagnosing AF in 4 cases; on the other hand, AFib correctly excluded AF in 167 and caused an erroneous diagnosis of AF in 2 cases. The Sensitivity was 0.895 (95 % CI 0.7597–0.958) and the Specificity was 0.988 (95 % CI 0.958–0.997). The AFib device global accuracy was 0.971 (95 % CI 0.938–0.987). This device was able to detect AF with high specificity and a good sensitivity. This device may be considered as an accurate tool in detecting AF in stroke patients.

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Acknowledgments

We thank the following components of the nursing team of our Stroke Unit who performed all evaluations by means of AFib device as well as the 12-lead-standard EKG recordings: Mr. Franco Bixio, Mrs. Paola Bruzzone, Mrs. Antonella Cuomo, Mrs. Cristina Forgione and the Head Nurse Mrs. Adria Ferrari. We also thank the Italian Association against Stroke (A.L.I.Ce.: “Associazione Lotta all’Ictus Cerebrale”) that provided free of charge, three AFib Microlife devices to perform the study.

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Authors and Affiliations

  1. Stroke Unit, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal-Infantile Health, University of Genoa, Largo Paolo Daneo, 3, 16132, Genoa, Italy

    C. Gandolfo, M. Balestrino, C. Bruno, C. Finocchi & N. Reale

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  1. C. Gandolfo
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  2. M. Balestrino
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  3. C. Bruno
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  4. C. Finocchi
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  5. N. Reale
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Correspondence to C. Gandolfo.

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Gandolfo, C., Balestrino, M., Bruno, C. et al. Validation of a simple method for atrial fibrillation screening in patients with stroke. Neurol Sci 36, 1675–1678 (2015). https://doi.org/10.1007/s10072-015-2231-0

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  • DOI: https://doi.org/10.1007/s10072-015-2231-0

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