Remote Screening for Atrial Fibrillation by a Federal Cardiac Monitoring System in Primary Care Patients in Russia: Results from the Prospective Interventional Multicenter FECAS-AFS Study

Global Heart

Philipp Kopylov¹  Dinara Mesitskaya²  Yulia Mitina³  Sergey Boytsov⁴  Mohamed Khiari⁵  Nelly Vishnyakova⁶  Hugo Saner⁷  Abram Syrkin⁸  Galina Ryabykina⁹  Petr Chomakhidze^1,10  Natalia Kuznetsova^1,11  Daria Gognieva^1,11 

[1] ARTORG Center for Biomedical Engineering Research, University of Bern, Bern;Assistant Professor, Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow;Department of Physiology, School of Biomedical Sciences, University of Melbourne, Melbourne;Department of new research methods, Federal State budget organization National medical research center of cardiology of the Ministry of healthcare of the Russian Federation, Moscow;Graduate Student, Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow;Head of Department, The state budgetary institution of health care of the Moscow region ‘Mytishchi city clinical hospital’, Mytishchi;Professor, Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, RU;Professor, Department of Cardiology, Functional and Ultrasound Diagnostics of N.V. Sklifosovsky Institute for Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow;Professor, Department of new research methods, Federal State budget organization National medical research center of cardiology of the Ministry of healthcare of the Russian Federation, Moscow;Professor, World-Class Research Center ‘Digital biodesign and personalized healthcare’ I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow;Researcher, World-Class Research Center ‘Digital biodesign and personalized healthcare’ I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow;

关键词: atrial fibrillation;    screening;    remote heart rhythm monitoring;    single-lead ecg;    anticoagulation therapy;    stroke;   

DOI  :  10.5334/gh.1057

来源: DOAJ

【 摘 要 】

Background: Screening for atrial fibrillation has the potential to significantly reduce cardiovascular morbidity and mortality. However, questions in regard to how to screen, on whom to screen, and the optimal setting of screening remain unanswered. Objective: To assess the applicability of a federal cardiac monitoring for atrial fibrillation (AF) screening and remote heart rhythm monitoring in patients at high cardiovascular risk in a mixed urban and rural population in Russia. Methods: This is a prospective multicenter cohort study including 3249 individuals with high cardiovascular risk (mean age 56 ± 12.8 years) from the larger Moscow region who were screened for AF using a smartphone-case based single-lead ECG monitor over a period of 18 month. The endpoints were considered as number of newly diagnosed AF; mean time to diagnosis; number of patients for the first time assigned to anticoagulation therapy; frequency of adverse events. Results: A trial fibrillation was diagnosed in 126 patients, 36 of them for the first time. The mean time to diagnosis was 3 ± 2 days. Of 36 patients, the CHA2DS2-VASc score was ≥1 in 34 cases, ≥2 in 29 cases. Anticoagulant therapy was first induced in 31 patients. One death in newly diagnosed group and two deaths in chronic group were registered. There were a total of eight hospitalizations: one in newly diagnosed and seven in chronic AF patients. Conclusion: Our results indicate that a Federal AF screening system in patients at high cardiovascular risk by using a smartphone-case based single lead ECG which is supported by centrally located ECG specialist and central data management is feasible and reliable when performed in a mixed urban and rural area. Further studies are needed to evaluate the full potential of this approach.

【 授权许可】

Unknown