Short-term ECG for out of hospital detection of silent atrial fibrillation episodes

Objectives. We evaluated a short-term ECG, thumb ECG, for detection of asymptomatic atrial fibrillation (AF) episodes. The aim was to evaluate registration efficacy, sensitivity, specificity, quality and feasibility in patients with special emphasis on asymptomatic AF. Design. One hundred patients registered their cardiac rhythm with 12-lead ECG immediately followed by thumb ECG. The registrations were compared blindly. A second group of 12 patients, who had successfully undergone cardioversion, performed rhythm registration twice daily for 30 days. A third group of 606 individuals underwent an AF screening procedure. Results. Thumb ECG correctly diagnosed AF (sensitivity) in 96% and sinus rhythm (specificity) in 92% compared with 12-lead ECG. In the group of cardioverted patients, 466 registrations were validated: 95% had satisfactory quality for diagnosis: four patients experienced AF recurrence in which three were asymptomatic. In the third group 12 persons were diagnosed with AF, six of these had neither symptoms nor a history of AF. Conclusions. Short-term ECG is able to diagnose AF with a high sensitivity, specificity and simple application making detection of asymptomatic AF possible for screening purposes.