Abstract 17869: Self-Detection of Atrial Fibrillation in an Aged Population - The LietoAF Study
Introduction: Atrial fibrillation (AF) is often asymptomatic and may remain undiagnosed until an ischemic stroke occurs. A key feature of AF is pulse irregularity.
Hypothesis: We hypothesize, that self-palpation of pulse is feasible in screening of AF in an aged population.
Methods: A total of 205 residents of the municipality of Lieto aged ≥75 years were randomly selected to take part in an intervention where a trained nurse gave a short individualized education on pulse palpation focusing on the evaluation of rhythm irregularity. The subjects were followed for three years and self-detected pulse irregularity and new AF diagnoses were recorded. The impact of the intervention on the subjects’ quality of life as measured by the EQ-5D-3L system and use of health care services during the follow up was assessed.
Results: The median age of the subjects was 78.2 [3.8] years, and 89 (43.4%) were men. In all, 139 (68%) subjects were deemed to have good motivation and capability for regular pulse palpation. At 4 months, 112 (80.6%) subjects with good and 26 (39.4%) with inadequate motivation/capability palpated their pulse daily. At 12 months, only 17 (8.3%) subjects palpated their pulse daily, but 103 (50.2%) still weekly. At 36 months, merely 34% continued palpation at least weekly. There were no differences in palpation activity by initial motivation/capability at 12 or 36 months. During the intervention, 67 (32.7%) subjects reported pulse irregularity. A total of 10 (4.9%) new cases of AF were found, in 8 of which the subject had reported pulse irregularity. However, only one (0.5%) sought urgent medical attention and was diagnosed with AF due to pulse irregularity. Three (1.5%) AFs were found during routine visits to the study center. Self-detected pulse irregularity was the only independent predictor of new AF. No significant changes were observed in quality of life or in the number of visits to primary or special health care clinics during the follow-up.
Conclusions: Pulse palpation can be learned even at an older age, but it seems to be challenging to make it into a continuing habit. Strategies to improve persistence of a regular pulse palpation habit and appropriate patient reactions to detected irregularities are crucial for more successful screening of AF.
Author Disclosures: J. Jaakkola: None. R. Virtanen: None. T. Vasankari: None. M. Salminen: None. K.J. Airaksinen: None.
- © 2016 by American Heart Association, Inc.