Evidence map›Paper›PMID 33741652›Full record

ArticleBMJ open quality2021

Single-lead ECGs (AliveCor) are a feasible, cost-effective and safer alternative to 12-lead ECGs in community diagnosis and monitoring of atrial fibrillation.

Jonathan James Hyett Bray, Elin Fflur Lloyd, Firdaus Adenwalla, Sarah Kelly, Kathie Wareham, Julian P J Halcox

Open access · goldAbstract read
In one paragraph

Article in BMJ open quality, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 31% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 4 institutions in 1 country.

Jonathan James Hyett Bray *Institute of Life Sciences 2, Swansea University Medical School, Swansea, UK Jonathan.bray@swansea.ac.uk.ORCID 0000-0003-1167-6295
Elin Fflur Lloyd *Cardiology, Swansea Bay University Health Board, Port Talbot, Neath Port Talbot, UK.
Firdaus AdenwallaSwansea Bay University Health Board, Port Talbot, Neath Port Talbot, UK.
Sarah KellySwansea Bay University Health Board, Port Talbot, Neath Port Talbot, UK.
Kathie WarehamInstitute of Life Sciences 2, Swansea University Medical School, Swansea, UK.
Julian P J HalcoxInstitute of Life Sciences 2, Swansea University Medical School, Swansea, UK.
Swansea Bay University Health Board · GBCardiff and Vale University Health Board · GBMorriston Hospital · GBSingleton Hospital · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCommunity management of atrial fibrillation (AF) often requires the use of electrocardiographic (ECG) investigation. Patients discharged following treatment of AF with fast ventricular response (fast AF) can require numerous ECGs to monitor rate and/or rhythm control. Single-lead ECGs have been proposed as a more convenient and relatively accurate alternative to 12-lead ECGs for rate/rhythm management and also diagnosis of AF. We aimed to examine the feasibility of using the AliveCor single-lead ECG monitor for diagnosis and monitoring of AF in the community setting.

methodsDuring the course of 6 months, this evaluation of a clinical service improvement pathway used the AliveCor in management of patients requiring (1) follow-up ECGs for AF with previously documented rapid ventricular rate or (2) ECG confirmation of rhythm where AF was suspected. Twelve AliveCor devices provided to the acute community medical team were used to produce 30 s ECG rhythm strips (iECG) that were electronically sent to an overreading physician.

resultsSeventy-four patients (mean age 82 years) were managed on this pathway. (1) The AliveCor was successfully used to monitor the follow-up of 37 patients with fast AF, acquiring a combined total of 113 iECGs (median 1.5 ±3.75 per patient). None of these patients required a subsequent 12-lead ECG and this approach saved an estimate of up to £134.49 per patient. (2) Of 53 patients with abnormal pulses, the system helped identify 8 cases of new onset AF and 19 cases of previously known AF that had reverted from sinus back into AF.

conclusionsWe have demonstrated that the AliveCor system is a feasible, cost-effective, time-efficient and potentially safer alternative to serial 12-lead ECGs for community monitoring and diagnosis of AF.

Indexed as

Atrial FibrillationAged, 80 and overCost-Benefit AnalysisElectrocardiographyHumansMonitoring, Physiologicclinical governancecommunity health servicescontinuous quality improvementcost-effectivenessquality improvement

Identifiers

PMID33741652
PMCPMC7986662
OpenAlexW3137779096

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.