Proposed Topic (Most preferred): :
Research and Innovations (new projects / technology / innovations / service models)
Authors (including presenting author) :
Wong YM, Chan PF, Lai KPL, Luk MHM, Fung HT, Yeung SW
Affiliation :
Department of Family Medicine and Primary Health Care, Kowloon East Cluster (KEC)
Introduction :
Atrial fibrillation (AF), the most common sustained arrhythmia, has become a global epidemic as a consequence of the ageing population and increased survival of chronic diseases. Higher prevalence of AF in patients with diabetes mellitus (DM) was demonstrated in different studies worldwide. However, the prevalence of AF in type 2 DM patients under primary care in Hong Kong was yet to be explored. Early detection of AF in DM patients can improve clinical outcomes by preventing thromboembolic stroke with the use of oral anticoagulants and strict glycemic control and hence reduce economic burden on patients and health care system. A study on targeted screening of atrial fibrillation using automated blood pressure measurement device with AF detection function in patients with type 2 diabetes mellitus in primary care was therefore carried out.
Objectives :
The study aimed to evaluate the prevalence of AF in patients with DM so as to provide evidence-based recommendations to incorporate AF screening as a component in regular diabetic risk and complication assessment. The performance of automated BP machine Microlife WatchBP Office AFIB as a screening tool for the detection of AF was also evaluated.
Methodology :
This was a cross-sectional study. All patients with type 2 DM who attended the regular diabetic risk and complication assessment in three KEC General Out-patient Clinics from 24 August 2021 to 27 January 2022 were recruited. Blood pressure measurement by Microlife WatchBP Office AFIB with AF detection function and 12 lead ECGs were performed for AF screening. Patients with AF newly detected were assessed by clinic family medicine specialists to confirm the diagnosis of AF.
Result & Outcome :
Among the 2,015 recruited DM patients, the prevalence of AF was found to be 1.9% (95% confidence interval [CI] 1.3 to 2.6). The prevalence of AF increased with age, from 0.5% in patients aged <65 years, to 2.2% in patients aged 65 - 74 years and 4.3% in patients aged ≥75 years. The sensitivity and specificity of Microlife WatchBP Office AFIB to detect AF were 80% (95% Cl 61.8-92.3) and 97.9% (95% CI 97.3-98.5) respectively. The positive and negative predictive values of the Microlife WatchBP Office AFIB to identify AF were 32.8% (95% CI 21.9–45.1) and 99.7% (95% CI 99.5-99.9) respectively.
AF screening with the use of Microlife WatchBP Office AFIB is a simple procedure and can be considered as a standard assessment in the regular comprehensive diabetic risk and complication assessment in primary care setting.
