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. 2022 Aug 12:9:956542.
doi: 10.3389/fcvm.2022.956542. eCollection 2022.

Sensitivity and specificity of automated blood pressure devices to detect atrial fibrillation: A systematic review and meta-analysis of diagnostic accuracy

Edmond W L Tang  1 , Benjamin H K Yip  1 , Chun-Pong Yu  2 , Samuel Y S Wong  1 , Eric K P Lee  1
Affiliations

Sensitivity and specificity of automated blood pressure devices to detect atrial fibrillation: A systematic review and meta-analysis of diagnostic accuracy

Edmond W L Tang et al. Front Cardiovasc Med. .

Abstract

Background: Atrial fibrillation (AF) is a prevalent and preventable cause of stroke and mortality.

Aim: This systematic review and meta-analysis aimed to investigate the sensitivity and specificity of office and out-of-office automated blood pressure (BP) devices to detect AF.

Methods: Diagnostic studies, extracted from databases such as Ovid Medline and Embase, on AF detection by BP device(s), electrocardiography, and reported sensitivity and specificity, were included. Screening of abstracts and full texts, data extraction, and quality assessment were conducted independently by two investigators using Covidence software. The sensitivity and specificity of the BP devices were pooled using a random-effects model.

Results: Sixteen studies including 10,158 participants were included. Only a few studies were conducted in primary care (n = 3) or with a low risk of bias (n = 5). Office BP devices, which utilised different algorithms to detect AF, had a sensitivity and specificity of 96.2 and 94%, respectively. Specificity was reduced when only one positive result was considered among consecutive BP measurements. Only a few studies (n = 3) investigated out-of-office BP. Only one study (n = 100) suggested the use of ≥79 and ≥26% of positive readings on 24-h ambulatory BP measurements to detect AF and paroxysmal AF, respectively.

Conclusions: Office BP devices can be used clinically to screen for AF in high-risk populations. Clinical trials are needed to determine the effect of AF screening using office BP devices in reducing stroke risk and mortality. Further studies are also required to guide out-of-office use of BP devices for detecting paroxysmal AF or AF.

Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022319541, PROSPERO CRD42022319541.

Keywords: atrial fibrillation; blood pressure; electrocardiogram (ECG); hypertension; meta-analysis; sensitivity and specificity.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flowchart.
Figure 2
Figure 2
Quality assessment.
Figure 3
Figure 3
Sensitivity and specificity of office blood pressure (BP) devices to detect atrial fibrillation (AF).
Figure 4
Figure 4
Ambulatory blood pressure measurement (ABPM) reading-to-reading (A) sensitivity and (B) specificity.
See this image and copyright information in PMC

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References

    1. Kalantarian S, Ay H, Gollub RL, Lee H, Retzepi K, Mansour M, et al. . Association between atrial fibrillation and silent cerebral infarctions: a systematic review and meta-analysis. Ann Intern Med. (2014) 161:650–8. 10.7326/M14-0538 - DOI - PMC - PubMed
    1. Leong DP, Eikelboom JW, Healey JS, Connolly SJ. Atrial fibrillation is associated with increased mortality: causation or association? Eur Heart J. (2013) 34:1027–30. 10.1093/eurheartj/eht044 - DOI - PubMed
    1. Papanastasiou CA, Theochari CA, Zareifopoulos N, Arfaras-Melainis A, Giannakoulas G, Karamitsos TD, et al. . Atrial fibrillation is associated with cognitive impairment, all-cause dementia, vascular dementia, and Alzheimer's disease: a systematic review and meta-analysis. J Gen Intern Med. (2021) 36:3122–35. 10.1007/s11606-021-06954-8 - DOI - PMC - PubMed
    1. Heeringa J, van der Kuip DA, Hofman A, Kors JA, van Herpen G, Stricker Ch BH, et al. . Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J. (2006) 27:949–53. 10.1093/eurheartj/ehi825 - DOI - PubMed
    1. Savelieva I, Camm AJ. Clinical relevance of silent atrial fibrillation: prevalence, prognosis, quality of life, and management. J Interv Card Electrophysiol. (2000) 4:369–82. 10.1023/A:1009823001707 - DOI - PubMed

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