Detection of hidden atrial fibrillation in primary care using a long-term band-based ECG registration system: The DESCUUBRE-FA study

J Stroke Cerebrovasc Dis. 2022 Sep;31(9):106642. doi: 10.1016/j.jstrokecerebrovasdis.2022.106642. Epub 2022 Jul 18.

Abstract

Objective: To assess whether the use of a band-based electrocardiographic (ECG) monitoring system improves the diagnostic accuracy of traditional diagnostic methods for the detection of atrial fibrillation (AF).

Methods: Multicenter and observational study of primary care patients at risk of AF. To be included, patients had to be aged ≥70 years, with no known AF, and have at least 1 major criterion (obesity, hyperthyroidism, heart failure) or 2 minor criteria (hypertension, diabetes, female sex, ischemic stroke, transient ischemic attack or systemic embolism, COPD, dyslipidemia, ischemic heart disease, peripheral artery disease). All patients were monitored using the Nuubo™ system for a single 2-week period.

Results: A total of 600 patients were included (median age 77 years; 70% women; 84.3% hypertension, 27.2% diabetes, 9.2% prior stroke). The global rate of diagnosis of new AF in the overall population was 2.83%. All patients with AF were anticoagulated. In numerical terms, patients with AF (vs no AF) had a higher number of supraventricular extrasystoles and episodes of supraventricular tachycardia, as well as longer P wave duration; however, these differences did not reach statistical significance. Overall, participants were very satisfied with the device, and no relevant limitations in daily activities were observed during the 2-week study period.

Conclusions: In an elderly population at risk of AF, a band-based ECG monitoring approach applied for only 2 weeks detected approximately 3% of new cases of AF, leading to a change in antithrombotic therapy. Most participants considered the device easy to use and comfortable.

Keywords: Atrial fibrillation; Long-term ECG monitoring; Nuubo; Stroke.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Atrial Fibrillation* / diagnosis
  • Diabetes Mellitus*
  • Electrocardiography
  • Electrocardiography, Ambulatory
  • Female
  • Humans
  • Hypertension* / diagnosis
  • Ischemic Attack, Transient*
  • Male
  • Primary Health Care
  • Prospective Studies
  • Risk Factors
  • Stroke* / diagnosis
  • Stroke* / etiology