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Open Access Research article

The diagnostic accuracy of the MyDiagnostick to detect atrial fibrillation in primary care

Bert Vaes12*, Silke Stalpaert1, Karen Tavernier1, Britt Thaels1, Daphne Lapeire1, Wilfried Mullens34 and Jan Degryse12

Author Affiliations

1 Department of General Practice, Katholieke Universiteit Leuven (KUL), Leuven, Belgium

2 Institute of Health and Society, Université Catholique de Louvain (UCL), Brussels, Belgium

3 Department of Cardiology, Ziekenhuis Oost Limburg, Genk, Belgium

4 Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Diepenbeek, Belgium

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BMC Family Practice 2014, 15:113  doi:10.1186/1471-2296-15-113

Published: 9 June 2014

Abstract

Background

Atrial fibrillation is very common in people aged 65 or older. This condition increases the risk of death, congestive heart failure and thromboembolic conditions. Many patients with atrial fibrillation are asymptomatic and a cerebrovascular accident (CVA) is often the first clinical presentation. Guidelines concerning the prevention of CVA recommend monitoring the heart rate in patients aged 65 or older. Recently, the MyDiagnostick (Applied Biomedical Systems BV, Maastricht, The Netherlands) was introduced as a new screening tool which might serve as an alternative for the less accurate pulse palpation. This study was designed to explore the diagnostic accuracy of the MyDiagnostick for the detection of atrial fibrillation.

Methods

A phase II diagnostic accuracy study in a convenience sample of 191 subjects recruited in primary care. The majority of participants were patients with a known history of atrial fibrillation (n = 161). Readings of the MyDiagnostick were compared with electrocardiographic recordings. Sensitivity and specificity and their 95% confidence interval were calculated using 2x2 tables.

Results

A prevalence of 54% for an atrial fibrillation rhythm was found in the study population at the moment of the study. A combination of three measurements with the MyDiagnostick for each patient showed a sensitivity of 94% (95% CI 87 – 98) and a specificity of 93% (95% CI 85 – 97).

Conclusion

The MyDiagnostick is an easy-to-use device that showed a good diagnostic accuracy with a high sensitivity and specificity for atrial fibrillation in a convenience sample in primary care. Future research is needed to determine the place of the MyDiagnostick in possible screening or case-finding strategies for atrial fibrillation.

Keywords:
Atrial fibrillation; Sensitivity and specificity; MyDiagnostick; Primary care