{"id":190,"date":"2017-06-28T11:40:08","date_gmt":"2017-06-28T11:40:08","guid":{"rendered":"http:\/\/www.pmsinstruments.co.uk\/blog\/?p=190"},"modified":"2018-01-19T14:33:59","modified_gmt":"2018-01-19T14:33:59","slug":"european-society-of-cardiology-diagnosis-and-timeley-detection-of-af","status":"publish","type":"post","link":"https:\/\/www.pmsinstruments.co.uk\/blog\/european-society-of-cardiology-diagnosis-and-timeley-detection-of-af\/","title":{"rendered":"European Society of Cardiology. Diagnosis and timeley detection of AF."},"content":{"rendered":"<p>&nbsp;<\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"color: #000000; font-family: Calibri;\">I have recently been re-reading the 2016 European Society of Cardiology (ESC) Guidelines for the management of atrial fibrillation (European Heart Journal (2016) 37, 2893\u20132962 doi:10.1093\/eurheartj\/ehw210.<\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"color: #000000; font-family: Calibri;\">Of particular interest was the section on \u201cDiagnosis and timely detection of atrial fibrillation\u201d especially in the light of the popularity of the low cost clinically validated Kardia Mobile ECG from AliveCor.<\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"color: #000000; font-family: Calibri;\">In their latest review, when putting forward proposals to enhance current guidelines the ESC specify 4 different recommendation classes. A Class I recommendation is defined as <\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"color: #000000; font-family: Calibri;\">\u201cEvidence and\/or general agreement that a given treatment or procedure is beneficial, useful, effective\u201d.<\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"font-family: Calibri;\"><span style=\"color: #000000;\">Within the section for screening for atrial fibrillation they have issued a class I recommendation that <span style=\"mso-spacerun: yes;\">\u00a0<\/span><\/span><\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"color: #000000; font-family: Calibri;\">\u201cOpportunistic screening for AF is recommended by pulse taking or ECG rhythm strip in patients &gt;65 years of age\u201d <\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"color: #000000; font-family: Calibri;\">Clearly that is advice worth taking but in a busy GP Practice, where appointment time is limited to 10 or 15 minutes and resources under pressure, is it always practical to carry out a 12 lead ECG to get a rhythm strip?<\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"color: #000000; font-family: Calibri;\">Fortunately technology has the answer and there is the Kardia Mobile ECG\u00a0App for that! <\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"font-family: Calibri;\"><span style=\"color: #000000;\">For under \u00a399 the Kardia Mobile and App produces a 30 second rhythm strip that has the same diagnostic accuracy as a 12 lead single channel ECG <i>Lau JK, Lowres N, Neubeck L, Brieger DB, Sy RW, Galloway CD, et al. Int J Cardiol. 2013;165(1):193-4.<\/i> <\/span><\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"mso-bidi-font-style: italic;\"><span style=\"color: #000000; font-family: Calibri;\">It is therefore ideal for use in Primary Care to implement the recommendations of the ESC. The ESC go on to say <\/span><\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"mso-bidi-font-style: italic;\"><span style=\"color: #000000; font-family: Calibri;\">\u201cThere is good evidence that prolonged ECG monitoring enhances the detection of undiagnosed AF, e.g. monitoring for 72 h after a stroke\u2026and daily short-term ECG recordings increase AF detection in populations over 75 years of age\u201d<\/span><\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"mso-bidi-font-style: italic;\"><span style=\"color: #000000; font-family: Calibri;\">Again the Kardia Mobile is ideally suited for regular home monitoring, for instance once in the morning and once in the afternoon. <\/span><\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"mso-bidi-font-style: italic;\"><span style=\"color: #000000; font-family: Calibri;\">As it records a 30 second rhythm strip in real time, it is ideal for capturing paroxysmal AF for later analysis by a GP or Cardiologist. <\/span><\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"mso-bidi-font-style: italic;\"><span style=\"color: #000000; font-family: Calibri;\">It can be used to replace manual pulse checks providing qualitative ECG evidence in 30 seconds.<\/span><\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"mso-bidi-font-style: italic;\"><span style=\"color: #000000; font-family: Calibri;\">There is also an association with high blood pressure and AF. The Kardia Mobile ECG can help here as well. <\/span><\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"mso-bidi-font-style: italic;\"><span style=\"color: #000000; font-family: Calibri;\">To save time during a consultation, as well as to opportunistically screen for AF, why not use a Kardia Mobile before taking a blood pressure reading? <\/span><\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"mso-bidi-font-style: italic;\"><span style=\"color: #000000; font-family: Calibri;\">In the UK NICE have provided guidance on this with NICE Guideline CG127 Hypertension in adults: diagnosis and management on whether to use an automatic or manual blood pressure device.<\/span><\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"mso-bidi-font-style: italic;\"><span style=\"color: #000000; font-family: Calibri;\">Clause 1.1.2 states<\/span><\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"mso-bidi-font-style: italic;\"><span style=\"color: #000000; font-family: Calibri;\">\u201cBecause automated devices may not measure blood pressure accurately if there is pulse irregularity (for example, due to atrial fibrillation), palpate the radial or brachial pulse before measuring blood pressure. If pulse irregularity is present, measure blood pressure manually using direct auscultation over the brachial artery.\u201d<\/span><\/span><\/p>\n<p style=\"margin: 0cm 0cm 8pt;\"><span style=\"mso-bidi-font-style: italic;\"><span style=\"color: #000000; font-family: Calibri;\">Using a clinically validated Kardia Mobile by AliveCor before taking a blood pressure reading can save time as well as ensuring the most appropriate (automatic or manual) BP device is used. For up to date independent reviews on the Kardia Mobile ECG or to purchase visit our website.<\/span><\/span><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>&nbsp; I have recently been re-reading the 2016 European Society of Cardiology (ESC) Guidelines for the management of atrial fibrillation (European Heart Journal (2016) 37, 2893\u20132962 doi:10.1093\/eurheartj\/ehw210. Of particular interest was the section on \u201cDiagnosis and timely detection of atrial fibrillation\u201d especially in the light of the popularity of the low cost clinically validated Kardia &hellip; <a href=\"https:\/\/www.pmsinstruments.co.uk\/blog\/european-society-of-cardiology-diagnosis-and-timeley-detection-of-af\/\" class=\"more-link\">Continue reading<span class=\"screen-reader-text\"> &#8220;European Society of Cardiology. Diagnosis and timeley detection of AF.&#8221;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","_links_to":"","_links_to_target":""},"categories":[40,34,33,89],"tags":[37,35,84,39],"_links":{"self":[{"href":"https:\/\/www.pmsinstruments.co.uk\/blog\/wp-json\/wp\/v2\/posts\/190"}],"collection":[{"href":"https:\/\/www.pmsinstruments.co.uk\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.pmsinstruments.co.uk\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.pmsinstruments.co.uk\/blog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pmsinstruments.co.uk\/blog\/wp-json\/wp\/v2\/comments?post=190"}],"version-history":[{"count":4,"href":"https:\/\/www.pmsinstruments.co.uk\/blog\/wp-json\/wp\/v2\/posts\/190\/revisions"}],"predecessor-version":[{"id":209,"href":"https:\/\/www.pmsinstruments.co.uk\/blog\/wp-json\/wp\/v2\/posts\/190\/revisions\/209"}],"wp:attachment":[{"href":"https:\/\/www.pmsinstruments.co.uk\/blog\/wp-json\/wp\/v2\/media?parent=190"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.pmsinstruments.co.uk\/blog\/wp-json\/wp\/v2\/categories?post=190"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.pmsinstruments.co.uk\/blog\/wp-json\/wp\/v2\/tags?post=190"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}