Show simple item record

 
dc.contributorVall d'Hebron Barcelona Hospital Campus
dc.contributor.authorBañeras Rius, Jordi
dc.contributor.authorPariggiano, Ivana
dc.contributor.authorRodenas Alesina, Eduardo
dc.contributor.authorOristrell Santamaria, Gerard
dc.contributor.authorEscalona Silva, Roxana Andreina
dc.contributor.authorMiranda Barrio, Berta
dc.contributor.authorRello Sabaté, Pau
dc.contributor.authorSoriano Colomé, Toni
dc.contributor.authorGordon Ramirez, Blanca
dc.contributor.authorBelahnech Pujol, Yassin
dc.contributor.authorGarcía-Dorado García, David
dc.contributor.authorFerreira González, Ignacio
dc.date.accessioned2022-09-07T11:15:53Z
dc.date.available2022-09-07T11:15:53Z
dc.date.issued2022-04-21
dc.identifier.citationBañeras J, Pariggiano I, Ródenas-Alesina E, Oristrell G, Escalona R, Miranda B, et al. Optimal opportunistic screening of atrial fibrillation using pulse palpation in cardiology outpatient clinics: Who and how. PLoS One. 2022 Apr 21;17(4):e0266955.
dc.identifier.issn1932-6203
dc.identifier.urihttp://hdl.handle.net/11351/8041
dc.descriptionNurses; Primary care; Heart failure
dc.description.abstractBackground Atrial fibrillation (AF) remain a prevalent undiagnosed condition frequently encountered in primary care. Objective We aimed to find the parameters that optimize the diagnostic accuracy of pulse palpation to detect AF. We also aimed to create a simple algorithm for selecting which individuals would benefit from pulse palpation and, if positive, receive an ECG to detect AF. Methods Nurses from four Cardiology outpatient clinics palpated 7,844 pulses according to a randomized list of arterial territories and durations of measure and immediately followed by a 12-lead ECG, which we used as the reference standard. We calculated the sensitivity and specificity of the palpation parameters. We also assessed whether diagnostic accuracy depended on the nurse’s experience or on a list of clinical factors of the patients. With this information, we estimated the positive predictive values and false omission rates according to very few clinical factors readily available in primary care (age, sex, and diagnosis of heart failure) and used them to create the algorithm. Results The parameters associated with the highest diagnostic accuracy were palpation of the radial artery and classifying as irregular those palpations in which the nurse was uncertain about pulse regularity or unable to palpate pulse (sensitivity = 79%; specificity = 86%). Specificity decreased with age. Neither the nurse’s experience nor any investigated clinical factor influenced diagnostic accuracy. We provide the algorithm to select the ≥40 years old individuals that would benefit from a pulse palpation screening: a) do nothing in <60 years old individuals without heart failure; b) do ECG in ≥70 years old individuals with heart failure; c) do radial pulse palpation in the remaining individuals and do ECG if the pulse is irregular or you are uncertain about its regularity or unable to palpate it. Conclusions Opportunistic screening for AF using optimal pulse palpation in candidate individuals according to a simple algorithm may have high effectiveness in detecting AF in primary care.
dc.language.isoeng
dc.publisherPublic Library of Science
dc.relation.ispartofseriesPLoS One;17(4)
dc.rightsAttribution 4.0 International
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.sourceScientia
dc.subjectElectrocardiografia
dc.subjectFibril·lació auricular - Diagnòstic
dc.subject.meshAtrial Fibrillation
dc.subject.mesh/diagnosis
dc.subject.meshElectrocardiography
dc.titleOptimal opportunistic screening of atrial fibrillation using pulse palpation in cardiology outpatient clinics: Who and how
dc.typeinfo:eu-repo/semantics/article
dc.identifier.doi10.1371/journal.pone.0266955
dc.subject.decsfibrilación atrial
dc.subject.decs/diagnóstico
dc.subject.decselectrocardiografía
dc.relation.publishversionhttps://doi.org/10.1371/journal.pone.0266955
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dc.audienceProfessionals
dc.contributor.organismesInstitut Català de la Salut
dc.contributor.authoraffiliation[Bañeras J, García-Dorado D] Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. CIBER CV, ISCIII, Madrid, Spain. [Pariggiano I] Division of Clinical Cardiology, A.O.R.N. "Sant’Anna e San Sebastiano", Caserta, Italy. Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy. [Ródenas-Alesina E, Oristrell G, Escalona R, Miranda B, Rello P, Soriano T, Gordon B, Belahnech Y] Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. [Ferreira-González I] Servei de Cardiologia, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Vall d’Hebron Institut de Recerca (VHIR), Barcelona, Spain. Vall d’Hebron Hospital Universitari, Barcelona, Spain. Universitat Autònoma de Barcelona, Bellaterra, Spain. CIBER ESP, ISC-III, Madrid, Spain
dc.identifier.pmid35446875
dc.identifier.wos000795468200067
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess


Files in this item

Thumbnail

This item appears in the following Collection(s)

Show simple item record