Detection of atrial fibrillation using a home blood pressure monitor

Abstract

Purpose: Atrial fibrillation (AF) is the most common arrhythmia and is associated with an increased risk of complications. A screening test has the potential to prevent AF-related complications. This study investigated the diagnostic accuracy of an automated device for home blood pressure (BP) monitoring, which implements an algorithm for AF detection. Patients and Methods: A modified, automated oscillometric device for home BP monitoring (Omron BP785N (HEM-7321-Z), Omron Healthcare) with an AF detector was used to measure the BP in patients. During each BP measurements, the electrocardiogram (ECG) was recorded simultaneously. Simultaneous BP measurements and ECG recordings were obtained from 99 subjects. Results: Twenty out of 20 patients with atrial fibrillation were correctly recognized by the device and the device correctly identified 67 patients with sinus rhythm as “Not-AF”. On the other hand, 12 patients with basic rhythm: sinus rhythm were incorrectly referred to as “atrial fibrillation”. In summary, the device has a diagnostic accuracy of 87.88% with a sensitivity of 100% and a specificity of 84.8%. On the other hand, in 23 patients, the raw data of the device showed that a body movement occurred during the measurement of the blood pressure. If these subjects were excluded of the analysis, then the diagnostic accuracy of the device would be even better, namely 90.79%. The sensitivity would be 100% and the specificity 89.5%. Conclusion: These data suggest that an automated device for home blood pressure has an excellent diagnostic accuracy for detecting an AF and could be used as a reliable screening test for early diagnosis of atrial fibrillation. Body movements have an impact of the accuracy and specificity of a blood pressure monitor.