[OP.2C.03] ASYMPTOMATIC ATRIAL FIBRILLATION: THE CASE FOR OPPORTUNISTIC SCREENING BY AUTOMATIC BLOOD PRESSURE MEASUREMENT IN THE COMMUNITY.

OBJECTIVE: Timely detection of atrial fibrillation (AF) may effectively prevent cardiovascular consequences. However, traditional diagnostic tools are either poorly reliable (pulse palpation) or not readily accessible (electrocardiogram, ECG) in the general practice. We tested whether an automatic oscillometric blood pressure (BP) monitor embedding an algorithm for AF detection might be effective for opportunistic screening of asymptomatic AF in the community.

DESIGN AND METHOD: 220 consecutive subjects from an unselected sample of individuals of a small Italian community were screened using a Microlife WatchBP Office BP monitor with patented AFIB algorithm. When, a possible AF was detected (at least 2 out of 3 BP measurements reporting AF) a doctor immediately performed a single-lead ECG in order to confirm or exclude the presence of the arrhythmia. Main demographic and clinical data were collected prior to any BP measurement.

RESULTS: In 12 of 220 subjects the device detected a possible AF during the BP measurement: in 4 of them (1.8%) the arrhythmia was confirmed by the ECG. In univariate analyses, subjects with AF were more likely to be older (77.0 ± 1.2 vs. 57.2 ± 15.2 years, p = 0.010), obese (50.0 vs. 14.4%, p = 0.048) and to suffer from a cardiovascular disease (50.0 vs. 10.6%, p = 0.014) than non-AF subjects. In a multivariate analysis, aged subjects had a 21% significantly larger risk of atrial fibrillation [odds ratio (95% confidence interval): 1.21 (1.02, 1.44), p = 0.031].

CONCLUSIONS: Opportunistic screening of AF by BP measurement, confirmed by ECG monitoring, is feasible to detect this arrhythmia in unaware subjects dwelled in the community.