Home Monitoring With a Modified Automatic Sphygmomanometer to Detect Recurrent Atrial Fibrillation

Objectives: Detecting asymptomatic atrial fibrillation would help identify patients who would benefit from anticoagulation. This study examined the application of a modified blood pressure monitor to screen for episodes of atrial fibrillation. Methods: A modified sphygmomanometer was designed to detect atrial fibrillation. The device has a sensitivity near 100% and a specificity of up to 91%. Therefore, this device can be expected to detect all episodes of atrial fibrillation. However, the lower specificity may result in false-positive readings that could prompt unnecessary clinic visits for electrocardiogram confirmation of the rhythm. Outpatients in sinus rhythm with a history of atrial fibrillation were given the device to monitor their pulse regularity once daily to detect atrial fibrillation. Patients with irregular readings were evaluated with an electrocardiogram. Results: Nineteen patients were monitored at home for a period ranging from 5 days to 5 months. Seven patients had recurrent atrial fibrillation identified by the monitor. Nine patients had no irregular readings for a mean of 82 ± 40 days. Of 19 patients, 3 had false-positive irregular readings that were a result of sinus arrhythmia or ectopy. Conclusions: The device had an acceptably low false-positive rate allowing 16 of 19 patients to use it at home for long-term atrial fibrillation monitoring. This device may help prevent strokes by identifying patients with prolonged episodes of asymptomatic atrial fibrillation who are candidates for anticoagulation.