Abstract:
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and a growing public health epidemic. In the UK, over 1.3 million people have a diagnosis of AF and an estimated 400,000 remain undiagnosed. AF-related strokes account for a quarter of all strokes and, as AF episodes are often asymptomatic, are still often the first manifestation of AF. Early diagnosis and initiation of oral anticoagulation, where appropriate, may prevent some of these thromboembolic strokes. Public Health England is committed to decrease the incidence of AF-related strokes and has sponsored initiatives aimed at improving AF detection by promoting the uptake of wearable technologies. However, the National Institute for Health and Care Excellence (NICE) has not recommended wearable technology in their recent AF diagnosis and management guidelines (NG196). Diagnostic accuracy of single-lead electrocardiography (ECG) generated by the latest iteration of wearable devices is excellent and, in many cases, superior to general practitioner interpretation of the 12-lead ECG. High-quality ECG from wearable devices that unequivocally shows AF can expedite AF detection. Otherwise, there is a real risk of delaying AF diagnosis with the potential of devastating consequences for patients and their families.
摘要:
心房颤动(AF)是最常见的持续性心律失常,也是一种日益严重的公共卫生流行病。在英国,超过130万人被诊断为房颤,估计有40万人仍未被诊断。与AF相关的中风占所有中风的四分之一,由于房颤发作通常无症状,通常仍然是房颤的第一个表现。早期诊断和开始口服抗凝治疗,在适当的情况下,可以预防一些血栓栓塞性中风。英国公共卫生部致力于降低房颤相关中风的发生率,并赞助了旨在通过促进可穿戴技术的采用来改善房颤检测的举措。然而,美国国家健康与护理卓越研究所(NICE)在其最近的AF诊断和治疗指南(NG196)中未推荐可穿戴技术.由最新迭代的可穿戴设备生成的单导联心电图(ECG)的诊断准确性非常出色,在许多情况下,优于全科医生对12导联心电图的解释。来自可穿戴设备的高质量ECG明确显示AF可以加快AF检测。否则,确实存在延迟房颤诊断的风险,可能给患者及其家属带来毁灭性后果.