Self-detection of atrial fibrillation in an aged population: three-year follow-up of the LietoAF intervention study
Abstract Background Atrial fibrillation (AF) is often asymptomatic and undiagnosed until an ischaemic stroke occurs. An irregular pulse is a key manifestation of AF. We assessed whether pulse self-palpation is feasible in screening of AF. Methods Altogether 205 residents of Lieto municipality aged ≥...
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| Format: | Article |
| Language: | English |
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BMC
2017-09-01
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| Series: | BMC Geriatrics |
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| Online Access: | http://link.springer.com/article/10.1186/s12877-017-0607-0 |
| _version_ | 1818268929650327552 |
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| author | Jussi Jaakkola Raine Virtanen Tuija Vasankari Marika Salminen K.E. Juhani Airaksinen |
| author_facet | Jussi Jaakkola Raine Virtanen Tuija Vasankari Marika Salminen K.E. Juhani Airaksinen |
| author_sort | Jussi Jaakkola |
| collection | DOAJ |
| description | Abstract Background Atrial fibrillation (AF) is often asymptomatic and undiagnosed until an ischaemic stroke occurs. An irregular pulse is a key manifestation of AF. We assessed whether pulse self-palpation is feasible in screening of AF. Methods Altogether 205 residents of Lieto municipality aged ≥75 years were randomized in 2012 to receive brief education on pulse palpation focusing on evaluating rhythm regularity. Self-detected pulse irregularity and new AF diagnoses were recorded, and the subjects’ quality of life and use of health care services were assessed during a three-year follow-up. Results The subjects’ median age was 78.2 [3.8] years, and 89 (43.4%) were men. Overall, 139 (68%) subjects had initial good motivation/capability for regular palpation. At four months, 112 (80.6%) subjects with good and 26 (39.4%) with inadequate motivation/capability palpated their pulse daily. At 12 months, 120 (58.5%) and at 36 months, 69 (33.7%) subjects palpated their pulse at least weekly. During the intervention, 67 (32.7%) subjects reported pulse irregularity. New AF was found in 10 (4.9%) subjects, 7 (70%) of whom had reported pulse irregularity. Pulse irregularity independently predicted new AF, but only one (0.5%) subject with new AF sought undelayed medical attention due to pulse irregularity. Quality of life and number of outpatient clinic visits remained unchanged during follow-up. Conclusion Pulse palpation can be learned also by the elderly, but it is challenging to form a continuing habit. The low persistence of pulse self-palpation limits its value in the screening of AF, and strategies to promote persistence and research on alternative screening methods are needed. Trial registration http://www.ClinicalTrials.gov identifier: NCT01721005. The trial was registered retrospectively on October 26, 2012. |
| first_indexed | 2024-12-12T20:46:18Z |
| format | Article |
| id | doaj.art-b1418853cf17478c83263f8401c7ba9e |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-12T20:46:18Z |
| publishDate | 2017-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-b1418853cf17478c83263f8401c7ba9e2022-12-22T00:12:34ZengBMCBMC Geriatrics1471-23182017-09-011711810.1186/s12877-017-0607-0Self-detection of atrial fibrillation in an aged population: three-year follow-up of the LietoAF intervention studyJussi Jaakkola0Raine Virtanen1Tuija Vasankari2Marika Salminen3K.E. Juhani Airaksinen4Heart Centre, Turku University Hospital and University of TurkuHeart Centre, Turku University Hospital and University of TurkuHeart Centre, Turku University Hospital and University of TurkuInstitute of Clinical Medicine, Family Medicine, University of TurkuHeart Centre, Turku University Hospital and University of TurkuAbstract Background Atrial fibrillation (AF) is often asymptomatic and undiagnosed until an ischaemic stroke occurs. An irregular pulse is a key manifestation of AF. We assessed whether pulse self-palpation is feasible in screening of AF. Methods Altogether 205 residents of Lieto municipality aged ≥75 years were randomized in 2012 to receive brief education on pulse palpation focusing on evaluating rhythm regularity. Self-detected pulse irregularity and new AF diagnoses were recorded, and the subjects’ quality of life and use of health care services were assessed during a three-year follow-up. Results The subjects’ median age was 78.2 [3.8] years, and 89 (43.4%) were men. Overall, 139 (68%) subjects had initial good motivation/capability for regular palpation. At four months, 112 (80.6%) subjects with good and 26 (39.4%) with inadequate motivation/capability palpated their pulse daily. At 12 months, 120 (58.5%) and at 36 months, 69 (33.7%) subjects palpated their pulse at least weekly. During the intervention, 67 (32.7%) subjects reported pulse irregularity. New AF was found in 10 (4.9%) subjects, 7 (70%) of whom had reported pulse irregularity. Pulse irregularity independently predicted new AF, but only one (0.5%) subject with new AF sought undelayed medical attention due to pulse irregularity. Quality of life and number of outpatient clinic visits remained unchanged during follow-up. Conclusion Pulse palpation can be learned also by the elderly, but it is challenging to form a continuing habit. The low persistence of pulse self-palpation limits its value in the screening of AF, and strategies to promote persistence and research on alternative screening methods are needed. Trial registration http://www.ClinicalTrials.gov identifier: NCT01721005. The trial was registered retrospectively on October 26, 2012.http://link.springer.com/article/10.1186/s12877-017-0607-0Atrial fibrillationAsymptomatic conditionsScreeningStroke |
| spellingShingle | Jussi Jaakkola Raine Virtanen Tuija Vasankari Marika Salminen K.E. Juhani Airaksinen Self-detection of atrial fibrillation in an aged population: three-year follow-up of the LietoAF intervention study BMC Geriatrics Atrial fibrillation Asymptomatic conditions Screening Stroke |
| title | Self-detection of atrial fibrillation in an aged population: three-year follow-up of the LietoAF intervention study |
| title_full | Self-detection of atrial fibrillation in an aged population: three-year follow-up of the LietoAF intervention study |
| title_fullStr | Self-detection of atrial fibrillation in an aged population: three-year follow-up of the LietoAF intervention study |
| title_full_unstemmed | Self-detection of atrial fibrillation in an aged population: three-year follow-up of the LietoAF intervention study |
| title_short | Self-detection of atrial fibrillation in an aged population: three-year follow-up of the LietoAF intervention study |
| title_sort | self detection of atrial fibrillation in an aged population three year follow up of the lietoaf intervention study |
| topic | Atrial fibrillation Asymptomatic conditions Screening Stroke |
| url | http://link.springer.com/article/10.1186/s12877-017-0607-0 |
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