Handbuch stroke unit


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ISBN: 951692131
FORMAT: PDF EPUB MOBI TXT
DATEIGROSSE: 13,62

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Handbuch stroke unit

Background: Detection of atrial fibrillation AF is one of the primary diagnostic goals for patients on a stroke unit. Physician-based manual analysis of continuous ECG monitoring is regarded as the gold standard for AF detection but requires considerable resources. Recently, automated computer-based analysis of RR intervals was established to simplify AF detection. The present prospective study analyzes both methods head to head regarding AF detection specificity, sensitivity, and overall effectiveness.

Methods: Consecutive stroke patients without history of AF or proof of AF in the admission ECG were enrolled over the period of 7 months. All patients received continuous ECG telemetry during the complete stay on the stroke unit. All ECGs underwent automated analysis by a commercially available program. Blinded to these results, all ECG tracings were also assessed manually. Sensitivity, specificity, time consumption, costs per day, and cost-effectiveness were compared.

Results: consecutive patients were enrolled AF was detected by manual ECG analysis on 37 days 6. Specificity of the automated algorithm was Patients with AF were older and had more often arterial hypertension, higher NIHSS at admission, more often left atrial dilatation, and a higher CHA2DS2-VASc score. Automation significantly reduced human resources but was more expensive compared to manual analysis alone. Conclusion: Automatic AF detection is highly specific, but sensitivity is relatively low.

Results of this study suggest that automated computer-based AF detection should be rather complementary to manual ECG analysis than replacing it. Keywords: Atrial fibrillation; Automated detection; Manual detection; SRAclinic; Stroke. Abstract Background: Detection of atrial fibrillation AF is one of the primary diagnostic goals for patients on a stroke unit.

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