Atrial Fibrillation Screening in Nursing Homes



Status:Completed
Conditions:Atrial Fibrillation
Therapuetic Areas:Cardiology / Vascular Diseases
Healthy:No
Age Range:Any
Updated:3/3/2019
Start Date:February 1, 2018
End Date:November 1, 2018

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Screening for Atrial Fibrillation in High-Risk Nursing Home Residents

This study was designed to screen high risk patients in nursing homes for atrial fibrillation
with intermittent electrocardiogram (ECG) recordings using a portable, smartphone-based,
mobile ECG recording device (Kardia Mobile, AliveCor, Inc.). The investigators hypothesized
that screening patients with 2 or more risk factors for atrial fibrillation would yield a
higher incidence of atrial fibrillation compared to prior studies.

This is a prospective study that enrolled 245 residents from 15 participating nursing homes
with ≥2 risk factors for atrial fibrillation. All residents gave informed consent or had a
legally appointed representative who could consent on their behalf. Exclusion criteria
included residents with a prior diagnosis of atrial fibrillation, continuous rhythm
monitoring over the past year, and pacemaker or implantable cardioverter defibrillator in
situ.

Screening was performed using the smartphone-based, mobile ECG recording device. Thirty
second rhythm recordings were obtained on each resident on four different occasions within a
month. All tracings were reviewed by a cardiologist and, in the case of any uncertainty, the
diagnosis of atrial fibrillation was confirmed by an electrophysiologist. When atrial
fibrillation was detected in a resident (primary endpoint), no further rhythm recordings were
performed and the resident's nursing facility was then notified of the diagnosis. Further
evaluation and treatment were directed by the resident's primary care physician.

All data were stored on a secure encrypted server with password protection. The investigators
used chi-square and t-test analyses to determine if there were significant differences in
demographic variables or risk factors for atrial fibrillation between residents with and
without atrial fibrillation. Logistic regression analysis determined if any combination of
risk factors was predictive of a positive atrial fibrillation screen.

Inclusion Criteria:

Nursing home residents with ≥2 of the following risk factors for atrial fibrillation:

- age ≥75 years

- female sex

- obstructive sleep apnea

- peripheral vascular disease

- diabetes mellitus

- obesity (body mass index [BMI] >30 kg/m2)

- hypertension

- congestive heart failure

Exclusion Criteria:

- prior diagnosis of AF

- continuous rhythm monitoring over the past year

- pacemaker or implantable cardioverter defibrillator in situ
We found this trial at
1
site
Buffalo, New York 14203
?
mi
from
Buffalo, NY
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