Kardia Mobile ( AliveCor Ltd , Mountain View , CA , USA ) is the most cost-effective option in a full incremental analysis .
Single time point lead-I ECG devices for the detection of AF in people with signs or symptoms of AF and an irregular pulse appear to be a cost-effective use of NHS re sources compared with MPP followed by a 12-lead ECG in primary or secondary care , 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 an increased risk of stroke and congestive heart failure .
Lead-I electrocardiogram ( ECG ) devices are h and held instruments that can be used to detect AF at a single time point in people who present with relevant signs or symptoms .
OBJECTIVE To assess the diagnostic test accuracy , clinical impact and cost-effectiveness of using single time point lead-I ECG devices for the detection of AF in people presenting to primary care with relevant signs or symptoms , and who have an irregular pulse compared with using manual pulse palpation ( MPP ) followed by a 12-lead ECG in primary or secondary care .
Stroke severity in atrial fibrillation. The Framingham Study.
BACKGROUND AND PURPOSE Stroke occurring with atrial fibrillation ( AF )  is more likely to be fatal or more severe than non-AF stroke based on clinical series , but data from prospect i ve epidemiological studies are sparse and inconsistent . METHODS Over 40-year follow-up of the original 5070 Framingham cohort , 501 initial ischemic strokes , including 103 with AF , were analyzed . Stroke severity was rated as none , mild , moderate , severe , or fatal . Since 1981 , functional status indicated by the Barthel index has been evaluated acutely and at 3 , 6 , and 12 months . Severity and functional status of AF strokes were compared with non-AF strokes using chi 2 test and Student 's t test . Thirty-day mortality was assessed by logistic regression analyses . RESULTS AF was associated with increased stroke severity ( P = .048 ) . Thirty-day mortality was greater in AF strokes than in non-AF strokes ( 25 % versus 14 % ) . The multivariate-adjusted odds ratio for 30-day mortality for AF subjects was 1.84 ( 95 % confidence interval , 1.04 to 3.27 ) . Since 1981 , follow-up was available for 150 initial ischemic strokes , including 30 with AF . Compared with the non-AF group , the AF group had poorer survival and more recurrences during 1 year of follow-up . The AF subjects had lower mean Barthel index scores acutely ( 29.6 versus 58.6 , P < .001 ) and at 3 months ( P = .005 ) , 6 months ( P = .003 ) , and 12 months ( P = .130 ) after stroke among survivors . CONCLUSIONS Ischemic stroke associated with AF was nearly twice as likely to be fatal as non-AF stroke . Recurrence was more frequent , and functional deficits were more likely to be severe among survivors . Since stroke is usually the initial manifestation of embolism in AF , prevention is critical to reducing disability and mortality
Kardia Mobile ( AliveCor Ltd , Mountain View , CA , USA ) is the most cost-effective option in a full incremental analysis .
Single time point lead-I ECG devices for the detection of AF in people with signs or symptoms of AF and an irregular pulse appear to be a cost-effective use of NHS re sources compared with MPP followed by a 12-lead ECG in primary or secondary care , 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 an increased risk of stroke and congestive heart failure .
Lead-I electrocardiogram ( ECG ) devices are h and held instruments that can be used to detect AF at a single time point in people who present with relevant signs or symptoms .
OBJECTIVE To assess the diagnostic test accuracy , clinical impact and cost-effectiveness of using single time point lead-I ECG devices for the detection of AF in people presenting to primary care with relevant signs or symptoms , and who have an irregular pulse compared with using manual pulse palpation ( MPP ) followed by a 12-lead ECG in primary or secondary care .