Kardia Mobile is the most cost effective option in a full incremental analysis .
Lead-I ECG tests may identify more AF cases than the st and ard diagnostic pathway .
This comes at a higher cost but with greater patient benefit in terms of mortality and quality of life .
Conclusions The use of single-time point lead-I ECG devices in primary care for the detection of AF in people with signs or symptoms of AF and an irregular pulse appears to be a cost effective use of NHS re sources compared with MPP followed by a 12-lead ECG , given the assumptions used in the base case model .
Background Atrial fibrillation ( AF ) is the most common type of cardiac arrhythmia and is associated with increased risk of stroke and congestive heart failure .
Lead-I electrocardiogram ( ECG ) devices are h and held instruments that can detect AF at a single-time point .
Purpose To assess the diagnostic test accuracy , clinical impact and cost effectiveness of single-time point lead-I ECG devices compared with manual pulse palpation ( MPP ) followed by a 12-lead ECG for the detection of AF in symptomatic primary care patients with an irregular pulse .
The diagnostic accuracy of the MyDiagnostick to detect atrial fibrillation in primary care
Background Atrial fibrillation is very common in people aged 65 or older . This condition increases the risk of death , congestive heart failure and thromboembolic conditions . Many patients with atrial fibrillation are asymptomatic and a cerebrovascular accident ( CVA ) is often the first clinical presentation . Guidelines concerning the prevention of CVA recommend monitoring the heart rate in patients aged 65 or older . Recently , the MyDiagnostick ( Applied Biomedical Systems BV , Maastricht , The Netherl and s ) was introduced as a new screening tool which might serve as an alternative for the less accurate pulse palpation . This study was design ed to explore the diagnostic accuracy of the MyDiagnostick for the detection of atrial fibrillation . Methods A phase II diagnostic accuracy study in a convenience sample of 191 subjects recruited in primary care . The majority of participants were patients with a known history of atrial fibrillation ( n = 161 ) .  Readings of the MyDiagnostick were compared with electrocardiographic recordings . Sensitivity and specificity and their 95 % confidence interval were calculated using 2x2 tables . Results A prevalence of 54 % for an atrial fibrillation rhythm was found in the study population at the moment of the study . A combination of three measurements with the MyDiagnostick for each patient showed a sensitivity of 94 % ( 95 % CI 87 – 98 ) and a specificity of 93 % ( 95 % CI 85 – 97 ) . Conclusion The MyDiagnostick is an easy-to-use device that showed a good diagnostic accuracy with a high sensitivity and specificity for atrial fibrillation in a convenience sample in primary care . Future research is needed to determine the place of the MyDiagnostick in possible screening or case-finding strategies for atrial fibrillation
Kardia Mobile is the most cost effective option in a full incremental analysis .
Lead-I ECG tests may identify more AF cases than the st and ard diagnostic pathway .
This comes at a higher cost but with greater patient benefit in terms of mortality and quality of life .
Conclusions The use of single-time point lead-I ECG devices in primary care for the detection of AF in people with signs or symptoms of AF and an irregular pulse appears to be a cost effective use of NHS re sources compared with MPP followed by a 12-lead ECG , given the assumptions used in the base case model .
Background Atrial fibrillation ( AF ) is the most common type of cardiac arrhythmia and is associated with increased risk of stroke and congestive heart failure .
Lead-I electrocardiogram ( ECG ) devices are h and held instruments that can detect AF at a single-time point .
Purpose To assess the diagnostic test accuracy , clinical impact and cost effectiveness of single-time point lead-I ECG devices compared with manual pulse palpation ( MPP ) followed by a 12-lead ECG for the detection of AF in symptomatic primary care patients with an irregular pulse .