Atrial Fibrillation Home Monitoring and Stroke
Atrial Fibrillation home monitoring by patients could offer early diagnosis and prevent strokes
People believe that stroke hits only the elderly, however the younger population can also be affected. Nearly one quarter of strokes occur in people under the age of 65. Early detection of (often asympomatic) causes could be improved with Atrial Fibrillation home monitoring.
Atrial Fibrillation, an abnormal heart rhythm, is responsible for 20% of strokes and is therefore the main cause of this heart disorder. People with Atrial Fibrillation have a 3 to 5 times increased stroke risk compared to patients without Atrial Fibrillation, but it is often asymptomatic and it is not always diagnosed early.
Approximately 0.5% of the population around the age of 50 has Atrial Fibrillation, however this increases up to 10% in people of more than 65 years of age. In Europe an estimated 4.5 million people are affected by Atrial Fibrillation with about 300,000 new cases each year.
Diagnosis of this condition is made mainly with an electrocardiogram (ECG or EKG) which shows the absence of P waves which are replaced by F waves, small irregular undulations. Until recently the method commonly utilized by a GP for a first screening is by taking a pulse at the radial artery at the wrist. Major world associations have supported this method for early screening of Atrial Fibrillation and prevention of stroke.
Home monitoring, with appropriate patient training, has become common place for heart patients and can be a useful part of a good self-management regime, with devices such as a blood pressure monitors. It is now possible to also provide early detection of Atrial Fibrillation, by the patient or clinician, with new home monitoring devices using ‘Afib technology’. (We recommend that patients who wish to self monitor blood pressure and Atrial Fibrillation ask for training from their healthcare professionals, to ensure the best results and to avoid over monitoring.)
Guidelines from he European Society of Hypertension (2010) also say that self-monitoring of blood pressure by patients at home is increasingly being used all over and is well accepted by hypertensive patients, with some advantages over surgery based monitoring. “In addition to conventional office measurements and ambulatory blood pressure monitoring, it has a useful adjunctive role in clinical practice. Not only does it take care of entities like white-coat hypertension and masked hypertension, it enables a more precise initial diagnosis of hypertension. It has also been shown to improve compliance with long term treatment.”
In regard to clinical trial data of a home blood pressure monitoring system with Atrial Fibrillation detection capabilities Professor Riccardo Capaato, President of the European Cardiac Arrhythmia society suggests that patients can now also be capable of identifying early problems. “The innovation is to leave the task of interpreting pulse irregularities to each one of us individually and not only to the doctor. Measuring one’s own heart rate is actually a simple and fast way to identify a heart problem that, if ignored, may be fatal.”
(Also see NICE medical technology guidance* for Afib technology, and specifically the Microlife Home BP monitors at the bottom of this page which state “If the case for adopting the technology is supported, then the technology has been found to offer advantages to patients and the NHS. The specific recommendations on individual technologies are not intended to limit use of other relevant technologies which may offer similar advantages…”)
Two studies conducted on a total of approximately 500 subjects have demonstrated that AFIB technology for the detection of Atrial Fibrillation based on automated blood pressure measurement by an oscillometric method has a high sensitivity (low false negatives) and specificity (low false positives) when compared to the standard electrocardiogram (ECG).
Are you interested in Atrial Fibrillation detection at home?
Our friends at Home GP are pleased to offer a MicroLife HOME-S unit exclusively for Pumping Marvellous and Heart Failure Aware readers. (Entry closes 5pm, 7 Aug 2015)
* NICE medical technology guidance [MTG13] Published date: January 2013.
“NICE medical technologies guidance addresses specific technologies notified to NICE by manufacturers. The ‘case for adoption’ recommendations are based on the claimed advantages of introducing the specific technology compared with current management of the condition. This ‘case’ is reviewed against the evidence submitted and expert advice. If the case for adopting the technology is supported, then the technology has been found to offer advantages to patients and the NHS. The specific recommendations on individual technologies are not intended to limit use of other relevant technologies which may offer similar advantages.
NICE has said the WatchBP Home A device is a useful option for people who are having their blood pressure checked in primary care (for example, at a GP surgery or clinic) because it could help to increase the number of people with atrial fibrillation who are diagnosed. If the device suggests that someone has atrial fibrillation, they should also have a test called an ECG (electrocardiogram) to confirm this.”