The results from an AF screening system, developed by Technomed have been published in the British Journal of Cardiology.
The goal, set by Dr. Matt Fay (National Clinical Lead, Stroke NHS Improvement Program) was to develop a rapid AF screening test that could be undertaken in less than 3 minutes whilst having better sensitivity and specificity than a pulse check.
[A pulse check followed by a confirmatory 12-lead ECG is the accepted standard screening test for detecting atrial fibrillation in the over 65 years age group. A pilot of 34,201 patients in North East Essex flu clinics yielded: 3154 patients (9.2%) with an irregular pulse 189 patients (0.55%) with unknown atrial fibrillation.]
Technomed developed their ECG CLOUD System which allowed a simple limb-lead ECG to be recorded within an appointment slot of less than 3 minutes. The ECG’s were transmitted to a remote cardiology expert and reported via a web browser interface. The results were returned on a next working day basis. Barcode data entry and a simplified electrode arrangement enabled 20 patients per hour to be processed per workstation.
The results of Technomed’s work in Bradford compared favourably with the yields obtained in North East Essex. Previously undiagnosed atrial fibrillation was detected in 1.06% of patients vs. 0.55%. The difference may reflect a higher incidence of undiagnosed AF in Bradford. Alternatively, 6 lead ECG may have better sensitivity for identifying AF compared with pulse palpation followed by 12 lead ECG, possibly days later. Certainly, specificity is far higher. Although manual pulse palpation is slightly faster than the ECG Cloud Rhythm Test it has a false positive rate of 94%.