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Screening for Atrial Fibrillation Using a Smartphone-Based Electrocardiogram in Korean Elderly

Chonnam Medical Journal 2020년 56권 1호 p.50 ~ 54
김누리 ( Kim Nu-Ri ) - Chonnam National University Hospital Gwangju-Jeonnam Regional Cardiocerebrovascular Center

최창균 ( Choi Chang-Kyun ) - Chonnam National University Medical School Department of Preventive Medicine
김형석 ( Kim Hyeong-Suk ) - Chonnam National University Hospital Gwangju-Jeonnam Regional Cardiocerebrovascular Center
오수현 ( Oh Su-Hyun ) - Chonnam National University Hospital Gwangju-Jeonnam Regional Cardiocerebrovascular Center
 ( Yang Jung-Hwa ) - Chonnam National University Hospital Gwangju-Jeonnam Regional Cardiocerebrovascular Center
이기홍 ( Lee Ki-Hong ) - Chonnam National University Hospital Department of Cardiology
김주한 ( Kim Ju-Han ) - Chonnam National University Hospital Department of Cardiology
박만석 ( Park Man-Seok ) - Chonnam National University Hospital Department of Neurology
김혜연 ( Kim Hye-Yeon ) - Chonnam National University Hospital Gwangju-Jeonnam Regional Cardiocerebrovascular Center
신민호 ( Shin Min-Ho ) - Chonnam National University Medical School Department of Preventive Medicine

Abstract


Atrial fibrillation (AF) is responsible for 10?20% of cerebral infarctions. Several mobile devices have been developed to screen for AF and studies of AF screening have been conducted in several countries to evaluate the applicability of these mobile devices. In this tradition, we conducted a community-based AF screening using an automated single-lead electrocardiogram (SL-ECG). This survey examined 2,422 participants in a community dementia screening program who were aged 60 years or older in the preliminary study, and 5,366 participants at 9 Senior Welfare Centers aged 60 years or older in the expanded study. AF screening was conducted using an automated SL-ECG (Kardia Mobile, AliveCor, Mountain View, CA, USA). AF was confirmed with a 12-lead electrocardiogram in subjects classified as having AF on the SL-ECG. In the preliminary study, of the 2,422 subjects, 124 had AF on the SL-ECG. The prevalence of AF was 3.0% (95% confidence interval [CI]: 2.4?3.8). The positive predictive value (PPV) of SL-ECG was 58.9% (95% CI: 50.1?67.1). Of the subjects diagnosed with AF, 65.8% (95% CI: 54.3?75.6) were newly diagnosed. In an expanded study, of the 5,366 subjects, 289 had AF on SL-ECG. The prevalence was 2.6% (95% CI: 2.2?3.1) and PPV of SL-ECG was 48.8% (95% CI: 43.1?54.5). In this community-based AF screening, we found that AF is underdiagnosed and undertreated. These results suggest that the early detection of AF using mobile devices is needed in Korea.

키워드

Atrial Fibrillation; Mass Screening; Electrocardiography
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