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Am J Cardiol. 2019 May 15;123(10):1643-1648. doi: 10.1016/j.amjcard.2019.02.028. Epub 2019 Feb 23.

Effectiveness of the Chest Strap Electrocardiogram to Detect Atrial Fibrillation.

Author information

1
Center for Prehospital Emergency Care, Kuopio University Hospital, Kuopio, Finland. Electronic address: sanna.hartikainen@kuh.fi.
2
University of Eastern Finland, Department of Applied Physics, Kuopio, Finland.
3
Center for Prehospital Emergency Care, Kuopio University Hospital, Kuopio, Finland.
4
Heart Center, North Karelia Central Hospital, Joensuu, Finland.
5
Heart Center, Kuopio University Hospital, Kuopio, Finland.
6
University of Eastern Finland, Department of Applied Physics, Kuopio, Finland; Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.
7
Department of Emergency Care, Kuopio University Hospital, Kuopio, Finland.
8
HYKS - Department of Emergency Medicine and Services, Helsinki University Hospital and Helsinki University, Helsinki, Finland.
9
University of Eastern Finland, Faculty of Health Sciences, Kuopio, Finland.
10
Center for Prehospital Emergency Care, Kuopio University Hospital, Kuopio, Finland; University of Eastern Finland, Faculty of Health Sciences, Kuopio, Finland.

Abstract

Atrial fibrillation (AF) is a significant cause of cardioembolic strokes. AF is often symptomless and intermittent, making its detection challenging. The aim of this study was to assess the possibility to use a chest strap (Suunto Movesense) to detect AF both by cardiologists and automated algorithms. A single channel electrocardiogram (ECG) from a chest strap of 220 patients (107 AF and 111 sinus rhythm SR with 2 inconclusive rhythms) were analyzed by 2 cardiologists (Doc1 and Doc2) and 2 different algorithms (COSEn and AFEvidence). A 3-lead Holter served as the gold standard ECG for rhythm analysis. Both cardiologists evaluated the quality of the chest strap ECG to be superior to the quality of the Holter ECG; p <0.05/p <0.001 (Doc1/Doc 2). Accurate automated algorithm-based AF detection was achieved with sensitivity of 95.3%/96.3% and specificity of 95.5/98.2% with 2 AF detection algorithms from chest strap and 93.5%/97.2% and 98.2%/95.5% from Holter, respectively. P waves were detectable in 93.7% (Doc1) and 94.6% (Doc2) of the cases from the chest strap ECG with sinus rhythm and 98.2% (Doc1) and 95.5% (Doc2) from the Holter (p = n.s). In conclusion, the ECGs from both methods enabled AF detection by a cardiologist and by automated algorithms. Both methods studied enabled P-wave detection in sinus rhythm.

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