ArticlePLoS medicine2020
Validity of daily self-pulse palpation for atrial fibrillation screening in patients 65 years and older: A cross-sectional study.
Article in PLoS medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 21 citations in OpenAlex.
- Newly diagnosed atrial fibrillation detected by noninvasive screening methods in clinical practice.Heart rhythm O2 · 2025Article
- Haemodynamic changes after atrial fibrillation initiation in patients eligible for catheter ablation: a randomized controlled study.European heart journal open · 2023Article
- Validity of MENARI plus (self-pulse assessment and clinical scoring) mobile apps for detecting atrial fibrillation in high-risk population.Journal of arrhythmia · 2023Article
- Searching for atrial fibrillation: looking harder, looking longer, and in increasingly sophisticated ways. An EHRA position paper.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023Article
- The pathway to diagnosis and follow-up care for atrial fibrillation in Sri Lanka: a descriptive longitudinal study.NIHR open research · 2023Article
- Smartphone and wearable detected atrial arrhythmias in Older Adults: Results of a fully digital European Case finding study.European heart journal. Digital health · 2022Article
- Performance of pulse palpation compared to one-lead ECG in atrial fibrillation screening.Clinical cardiology · 2021Article
- Large-scale screening studies for atrial fibrillation - is it worth the effort?Journal of internal medicine · 2021Review
- Atrial fibrillation prevalence and risk profile from novel community-based screening in Thailand: A prospective multi-centre study.International journal of cardiology. Heart & vasculature · 2021Article
- Opportunistic screening for atrial fibrillation by clinical pharmacists in UK general practice during the influenza vaccination season: A cross-sectional feasibility study.PLoS medicine · 2020Article
- Self-palpation for detection of paroxysmal atrial fibrillation: Much noise with little signal.PLoS medicine · 2020Article
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4 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundThe European Society of Cardiology guidelines recommend (Class IA) single-time-point screening for atrial fibrillation (AF) using pulse palpation. The role of pulse palpation for AF detection has not been validated against electrocardiogram (ECG) recordings. We aimed to study the validity of AF screening using self-pulse palpation compared with an ECG recording conducted at the same time using a handheld ECG 3 times a day for 2 weeks. METHODS AND
findingsIn this cross-sectional screening study, patients 65 years of age and older attending 4 primary care centers (PCCs) outside Stockholm County were invited to take part in AF screening from July 2017 to December 2018. Patients were included irrespective of their reason for visiting the PCC. Handheld intermittent ECGs 3 times per day were offered to patients without AF for a period of 2 weeks, and patients were instructed in how to take their own pulse at the same time. A total of 1,010 patients (mean age 73 years, 61% female, with an average CHA2DS2-VASc score 2.9) participated in the study, and 27 (2.7%, 95% CI 1.8%-3.9%) new cases of AF were detected. Anticoagulants (ACs) could be initiated in 26 (96%, 95% CI 81%-100%) of these cases. A total of 53,782 simultaneous ECG recordings and pulse measurements were registered. AF was verified in 311 ECG recordings, of which the pulse was palpated as irregular in 77 recordings (25%, 95% CI 20%-30% sensitivity per measurement occasion). Of the 27 AF cases, 15 cases felt an irregular pulse on at least one occasion (56%, 95% CI 35%-75% sensitivity per individual). 187 individuals without AF felt an irregular pulse on at least one occasion. The specificity per measurement occasion and per individual was (98%, 95% CI 98%-98%) and (81%, 95% CI 78%-83%), respectively.
conclusionsAF screening using self-pulse palpation 3 times daily for 2 weeks has lower sensitivity compared with simultaneous intermittent ECG. Thus, it may be better to screen for AF using intermittent ECG without stepwise screening using pulse palpation. A limitation of this model could be the reduced availability of handheld ECG recorders in primary care centers.
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