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Heartbeat: ECG approaches to early detection of atrial fibrillation
Heart ( IF 5.1 ) Pub Date : 2021-11-01 , DOI: 10.1136/heartjnl-2021-320418
Catherine M Otto 1
Affiliation  

Atrial fibrillation (AF) is a major cause of morbidity and mortality with an increasing prevalence in our ageing population. Yet, we have few effective approaches to identifying patients at risk of AF so that many patients are diagnosed only when they present with a stroke or heart failure. In this issue of Heart , Sanz-Garcia and colleagues1 present a simple ECG-based score that predicts subsequent AF with a predictive value area under the curve (AUC) of 0.776 (95% CI: 0.738 to 0.814). This computer assisted ECG approach was developed and validated in a cohort of 16 316 patients with the risk score based on age (up to four points), P wave duration in lead aVF (>200 ms, 2 points) and lead V4 (>150 ms, 0.7 point), T wave duration in lead V3 >250 ms (0.4 point), mean QTc interval >450 ms (0.3 point), transverse P wave clockwise rotation (0.3 point) and frontal QRS complex clockwise rotation (0.4 point) (figure 1). Figure 1 Probability of AF based on risk score values. Bars show the number of patients in the training cohort for each score value (non-AF in grey and AF in black). The trend line shows the estimated probability of AF. The table below represents the percentage of patients in the training cohort for each score value. AF, atrial fibrillation. In the accompanying editorial, Kashou and Noseworthy2 point out that, compared with clinical AF …

中文翻译:

心跳:早期检测心房颤动的心电图方法

心房颤动 (AF) 是发病率和死亡率的主要原因,在我们老龄化人口中的患病率不断增加。然而,我们几乎没有有效的方法来识别有 AF 风险的患者,因此许多患者仅在出现中风或心力衰竭时才被诊断出来。在本期 Heart 中,Sanz-Garcia 及其同事 1 提出了一个简单的基于心电图的评分,该评分可预测随后的 AF,其曲线下面积 (AUC) 为 0.776(95% CI:0.738 至 0.814)。这种计算机辅助心电图方法是在 16 316 名患者的队列中开发和验证的,风险评分基于年龄(最多 4 分)、aVF 导联的 P 波持续时间(>200 毫秒,2 分)和 V4 导联(>150 ms,0.7 分),V3 导联 T 波持续时间 >250 ms(0.4 分),平均 QTc 间期 >450 ms(0.3 分),横向 P 波顺时针旋转(0.3 点)和额叶 QRS 波群顺时针旋转(0.4 点)(图 1)。图 1 基于风险评分值的 AF 概率。条形显示每个评分值(灰色为非 AF,黑色为 AF)的训练队列中的患者数量。趋势线显示 AF 的估计概率。下表代表每个评分值在训练队列中的患者百分比。AF,心房颤动。在随附的社论中,Kashou 和 Noseworthy2 指出,与临床 AF 相比…… 下表代表每个评分值在训练队列中的患者百分比。AF,心房颤动。在随附的社论中,Kashou 和 Noseworthy2 指出,与临床 AF 相比…… 下表代表每个评分值在训练队列中的患者百分比。AF,心房颤动。在随附的社论中,Kashou 和 Noseworthy2 指出,与临床 AF 相比……
更新日期:2021-10-27
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