McDonagh, S. T.J., Rhodes, S., Warren, F. C., Keenan, S., Pentecost, C., Keeling, P., James, M., Taylor, R. S. and Clark, C. E. (2022) Performance of the imPulse device for the detection of atrial fibrillation in hospital settings. Cardiovascular Digital Health Journal, 3(4), pp. 171-178. (doi: 10.1016/j.cvdhj.2022.05.002) (PMID:36046429) (PMCID:PMC9422064)
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Abstract
Background: Atrial fibrillation (AF) increases thromboembolism and stroke risk; this can be reduced by oral anticoagulation, but only if AF is detected. A portable, point-of-care device, capable of accurately detecting and identifying AF, could reduce workload and diagnostic delay by minimizing need for follow-up 12-lead electrocardiogram (ECGs). Objective: To assess the diagnostic performance of the Plessey imPulse lead I ECG device compared with a 12-lead ECG in detecting AF. Methods: Cross-sectional diagnostic accuracy study. Participants underwent simultaneous 12-lead ECG and imPulse device recordings. The imPulse device reports AF to be “probable,” “possible,” “unlikely,” or “uncontrolled AF unlikely.” imPulse and ECG reference results were cross-tabulated; sensitivity, specificity, positive/negative predictive values, and positive/negative likelihood ratios with 95% confidence interval (CI) were estimated based on different imPulse device report categorizations and heart rate subgroups. Results: A total of 217 participants were recruited (mean age 70.2 [standard deviation 12.7]), 56% male, 57% outpatients, 43% inpatients) and 199 were included in analyses. AF was diagnosed on ECG for 41 of 199 (20.6%) participants and reported by imPulse as possible, probable, or uncontrolled AF unlikely present for 49 of 199 (24.6%). Sensitivity and specificity for imPulse detection of possible, probable, or uncontrolled AF unlikely vs unlikely, compared with ECG, were 80.5% (95% CI, 65.1%–91.2%) and 89.9% (84.1%–94.1%), respectively. When probable or uncontrolled AF unlikely were compared vs possible or unlikely AF, sensitivity and specificity were 63.4% (46.9%–77.9%) and 98.1% (94.6%–99.6%), respectively. Conclusion: The imPulse device has moderate sensitivity and good specificity compared with ECG AF detection in a hospital setting.
Item Type: | Articles |
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Additional Information: | This study was funded by Plessey Semiconductors Ltd. |
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Taylor, Professor Rod |
Authors: | McDonagh, S. T.J., Rhodes, S., Warren, F. C., Keenan, S., Pentecost, C., Keeling, P., James, M., Taylor, R. S., and Clark, C. E. |
College/School: | College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU |
Journal Name: | Cardiovascular Digital Health Journal |
Publisher: | Elsevier |
ISSN: | 2666-6936 |
ISSN (Online): | 2666-6936 |
Published Online: | 26 May 2022 |
Copyright Holders: | Copyright © 2022 The Authors |
First Published: | First published in Cardiovascular Digital Health Journal 3(4):171-178 |
Publisher Policy: | Reproduced under a Creative Commons License |
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