1
|
Ho JS, Ho ES, Yeo LL, Kong WK, Li TY, Tan BY, Chan MY, Sharma VK, Poh KK, Sia CH. Use of wearable technology in cardiac monitoring after cryptogenic stroke or embolic stroke of undetermined source: a systematic review. Singapore Med J 2024; 65:370-379. [PMID: 38449074 DOI: 10.4103/singaporemedj.smj-2022-143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 05/28/2023] [Indexed: 03/08/2024]
Abstract
INTRODUCTION Prolonged cardiac monitoring after cryptogenic stroke or embolic stroke of undetermined source (ESUS) is necessary to identify atrial fibrillation (AF) that requires anticoagulation. Wearable devices may improve AF detection compared to conventional management. We aimed to review the evidence for the use of wearable devices in post-cryptogenic stroke and post-ESUS monitoring. METHODS We performed a systematic search of PubMed, EMBASE, Scopus and clinicaltrials.gov on 21 July 2022, identifying all studies that investigated the use of wearable devices in patients with cryptogenic stroke or ESUS. The outcomes of AF detection were analysed. Literature reports on electrocardiogram (ECG)-based (external wearable, handheld, patch, mobile cardiac telemetry [MCT], smartwatch) and photoplethysmography (PPG)-based (smartwatch, smartphone) devices were summarised. RESULTS A total of 27 relevant studies were included (two randomised controlled trials, seven prospective trials, 10 cohort studies, six case series and two case reports). Only four studies compared wearable technology to Holter monitoring or implantable loop recorder, and these studies showed no significant differences on meta-analysis (odds ratio 2.35, 95% confidence interval [CI] 0.74-7.48, I 2 = 70%). External wearable devices detected AF in 20.7% (95% CI 14.9-27.2, I 2 = 76%) of patients and MCT detected new AF in 9.6% (95% CI 7.4%-11.9%, I 2 = 56%) of patients. Other devices investigated included patch sensors, handheld ECG recorders and PPG-based smartphone apps, which demonstrated feasibility in the post-cryptogenic stroke and post-ESUS setting. CONCLUSION Wearable devices that are ECG or PPG based are effective for paroxysmal AF detection after cryptogenic stroke and ESUS, but further studies are needed to establish how they compare with Holter monitors and implantable loop recorder.
Collapse
Affiliation(s)
- Jamie Sy Ho
- Department of Medicine, Alexandra Hospital, Singapore
| | - Elizabeth Sy Ho
- Department of Computer Science and Technology, University of Cambridge, Cambridge, UK
| | - Leonard Ll Yeo
- Division of Neurology, Department of Medicine, National University Health System, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - William Kf Kong
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Cardiology, National University Heart Centre Singapore, Singapore
| | - Tony Yw Li
- Department of Cardiology, National University Heart Centre Singapore, Singapore
| | - Benjamin Yq Tan
- Division of Neurology, Department of Medicine, National University Health System, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Mark Y Chan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Cardiology, National University Heart Centre Singapore, Singapore
| | - Vijay K Sharma
- Division of Neurology, Department of Medicine, National University Health System, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kian-Keong Poh
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Cardiology, National University Heart Centre Singapore, Singapore
| | - Ching-Hui Sia
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Cardiology, National University Heart Centre Singapore, Singapore
| |
Collapse
|
2
|
Ishihara Y, Ishizawa M, Noma T, Ohara M, Tani R, Kurashita G, Toda Y, Kobayashi W, Minamino T. Diagnostic Performance of an Automated Blood Pressure Monitor With an Irregular Heartbeat Algorithm Designed to Detect Atrial Fibrillation. Circ Rep 2024; 6:110-117. [PMID: 38606415 PMCID: PMC11004033 DOI: 10.1253/circrep.cr-24-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 02/08/2024] [Indexed: 04/13/2024] Open
Abstract
Background: Early detection of atrial fibrillation (AF) remains an unsolved challenge and because the greatest risk factor for AF is hypertension, blood pressure (BP) monitors with AF detectors have been developed. We evaluated the clinical performance of an irregular heartbeat (IHB) algorithm built into an A&D automated BP monitor for AF diagnosis. Methods and Results: Each of the 239 enrolled patients underwent BP measurement 3 times using the A&D UM-212 with the IHB algorithm. Real-time 3-lead ECG was recorded using automated ECG analysis software. Independent of the ECG analysis software results, 2 cardiologists interpreted the ECG and made the final diagnosis. Of the 239 patients, 135 were in sinus rhythm, 31 had AF, and 73 had non-AF arrhythmias. The respective sensitivity, specificity, and accuracy of the IHB algorithm for AF diagnosis were 98.9%, 91.2%, and 92.2% for the per-measurement evaluation, and 96.8%, 95.7%, and 95.8% for the per-patient evaluation (3/3 positive measurements). The respective sensitivity, specificity, and accuracy of the ECG analysis software for AF diagnosis were 91.4%, 97.9%, and 97.1% for the per-measurement evaluation, and 77.4%, 99.5%, and 96.7% for the per-patient evaluation (3/3 positive measurements). Conclusions: The IHB algorithm built into an A&D automated BP monitor had high diagnostic performance for AF in general cardiology patients, especially when multiple measurements were obtained.
Collapse
Affiliation(s)
- Yu Ishihara
- Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University Kagawa Japan
| | - Makoto Ishizawa
- Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University Kagawa Japan
| | - Takahisa Noma
- Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University Kagawa Japan
| | - Minako Ohara
- Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University Kagawa Japan
| | - Ryosuke Tani
- Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University Kagawa Japan
| | - Genki Kurashita
- Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University Kagawa Japan
| | - Yuta Toda
- Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University Kagawa Japan
| | - Waki Kobayashi
- Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University Kagawa Japan
| | - Tetsuo Minamino
- Department of Cardiorenal and Cerebrovascular Medicine, Faculty of Medicine, Kagawa University Kagawa Japan
| |
Collapse
|
3
|
Chao TF, Potpara TS, Lip GY. Atrial fibrillation: stroke prevention. THE LANCET REGIONAL HEALTH. EUROPE 2024; 37:100797. [PMID: 38362551 PMCID: PMC10867001 DOI: 10.1016/j.lanepe.2023.100797] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 11/11/2023] [Accepted: 11/15/2023] [Indexed: 02/17/2024]
Abstract
Stroke prevention is central to the management of patients with atrial fibrillation (AF) which has moved towards a more holistic or integrative care approach. The published evidence suggests that management of AF patients following such a holistic approach based on the Atrial fibrillation Better Care (ABC) pathway is associated with a lower risk of stroke and adverse events. Risk assessment, re-assessment and use of direct oral anticoagulants (DOACs) are important for stroke prevention in AF. The stroke and bleeding risks of AF patients are not static and should be re-assessed regularly. Bleeding risk assessment is to address and mitigate modifiable bleeding risk factors, and to identify high bleeding risk patients for early review and follow-up. Well-controlled comorbidities and healthy lifestyles also play an important role to achieve a better clinical outcome. Digital health solutions are increasingly relevant in the diagnosis and management of patients with AF, with the potential to improve stroke prevention. In this review, we provide an update on stroke prevention in AF, including importance of holistic management, risk assessment/re-assessment, and stroke prevention for special AF populations. Evidence-based and structured management of AF patients would reduce the risk of stroke and other adverse events.
Collapse
Affiliation(s)
- Tze-Fan Chao
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tatjana S. Potpara
- School of Medicine, University of Belgrade, Belgrade, Serbia
- Cardiology Clinic, Clinical Centre of Serbia, Belgrade, Serbia
| | - Gregory Y.H. Lip
- Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| |
Collapse
|
4
|
Henson C, Rambaldini B, Freedman B, Carlson B, Parter C, Christie V, Skinner J, Meharg D, Kirwan M, Ward K, Speier SN'Ḵ', Gwynne K. Wearables for early detection of atrial fibrillation and timely referral for Indigenous people ≥55 years: mixed-methods protocol. BMJ Open 2024; 14:e077820. [PMID: 38199631 PMCID: PMC10806615 DOI: 10.1136/bmjopen-2023-077820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
INTRODUCTION Digital health technologies have the potential to provide cost-effective care to remote and underserved populations. To realise this potential, research must involve people not traditionally included. No research focuses on the acceptability and feasibility of older Indigenous people using wearables for early atrial fibrillation (AF) detection. This protocol compares digital augmentation against standard practice to detect AF, evaluate heart health self-efficacy and health literacy changes and identify barriers in collaboration with Aboriginal Community Controlled Health Organisations. It will establish a framework for implementing culturally safe and acceptable wearable programmes for detecting and managing AF in Indigenous adults ≥55 years and older. METHODS This mixed-methods research will use the Rambaldini model of collective impact, a user-centred, co-design methodology and yarning circles, a recognised Indigenous research methodology to assess the cultural safety, acceptability, feasibility and efficacy of incorporating wearables into standard care for early AF detection. ANALYSIS Qualitative data will be analysed to create composite descriptions of participants' experiences and perspectives related to comfort, cultural safety, convenience, confidence, family reactions and concerns. Quantitative device data will be extracted and analysed via Statistical Product and Service Solutions (SPSS). CONCLUSION Prioritising perspectives of older Indigenous adults on using wearables for detecting and monitoring cardiovascular disease will ensure that the findings are effective, relevant and acceptable to those impacted. ETHICS AND DISSEMINATION Findings will be published in open-source peer-reviewed journals, shared at professional conferences, described in lay terms and made available to the public. The AHMRC HREC Reference Number approved 1135/15.
Collapse
Affiliation(s)
- Connie Henson
- Heart Research Institute Ltd, Newtown, New South Wales, Australia
- Djurali Centre for Aboriginal and Torres Strait Islander Research and Education, Sydney, NSW, Australia
- Indigenous Studies, Division of Vice Chancellor & President, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Boe Rambaldini
- Heart Research Institute Ltd, Newtown, New South Wales, Australia
- Djurali Centre for Aboriginal and Torres Strait Islander Research and Education, Sydney, NSW, Australia
- Indigenous Studies, Division of Vice Chancellor & President, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Ben Freedman
- Heart Research Institute Ltd, Newtown, New South Wales, Australia
- Dept of Cardiology, Concord Clinical School, Concord Hospital, Sydney, NSW, Australia
| | - Bronwyn Carlson
- Indigenous Studies, Macquarie University Faculty of Arts, North Ryde, New South Wales, Australia
- Centre for Global Indigenous Futures, Macquarie University Faculty of Arts, North Ryde, New South Wales, Australia
| | - Carmen Parter
- Heart Research Institute Ltd, Newtown, New South Wales, Australia
- Djurali Centre for Aboriginal and Torres Strait Islander Research and Education, Sydney, NSW, Australia
- Indigenous Studies, Division of Vice Chancellor & President, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Vita Christie
- Heart Research Institute Ltd, Newtown, New South Wales, Australia
- Djurali Centre for Aboriginal and Torres Strait Islander Research and Education, Sydney, NSW, Australia
- Indigenous Studies, Division of Vice Chancellor & President, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - John Skinner
- Heart Research Institute Ltd, Newtown, New South Wales, Australia
- Djurali Centre for Aboriginal and Torres Strait Islander Research and Education, Sydney, NSW, Australia
- Indigenous Studies, Division of Vice Chancellor & President, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - David Meharg
- Faculty of Medicine and Health, School of Health Sciences, The University of Sydney, Sydney, NSW, Australia
| | - Morwenna Kirwan
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Katrina Ward
- Brewarrina Aboriginal Medical Service, Brewarrina, New South Wales, Australia
| | | | - Kylie Gwynne
- Heart Research Institute Ltd, Newtown, New South Wales, Australia
- Djurali Centre for Aboriginal and Torres Strait Islander Research and Education, Sydney, NSW, Australia
- Indigenous Studies, Division of Vice Chancellor & President, University of New South Wales (UNSW), Sydney, NSW, Australia
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| |
Collapse
|
5
|
Chao TF, Yeh YH, Chan YH, Lin FJ, Chen TH, Pan KL, Lin JC, Lin YJ, Chen SA. The Report of Community-Based and Government-Endorsed Screening Program of Atrial Fibrillation in Taiwan. Thromb Haemost 2024; 124:61-68. [PMID: 37434320 DOI: 10.1055/a-2127-0690] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2023]
Abstract
BACKGROUND Although international guidelines recommended opportunistic screening for atrial fibrillation (AF), the community-based AF screening program incorporated into the government-endorsed health care system is rarely reported in Asian countries. OBJECTIVES We aimed to test the feasibility of adding AF screening into the preexistent adult health check program and report the AF detection rate and percentages of OAC prescriptions before and after AF screening with the involvement of public health care systems. METHODS We performed this program in three counties (Chiayi county, Keelung City, and Yilan county) in Taiwan which have their own official preexistent adult health check programs conducted by public health bureaus for years. However, electrocardiography (ECG) was not included in these programs before. We cooperated with the public health bureaus of the three counties and performed single-lead 30-second ECG recording for every participant. RESULTS From January to December 2020, AF screening was performed in 199 sessions with 23,572 participants. AF was detected in 278 subjects with a detection rate of 1.19% (age ≥65 years: 2.39%; ≥75 years: 3.73%). The mean CHA2DS2-VASc score of these 278 subjects was 2.36, with 91% of them had a score ≥1 (males) or ≥2 (females). The number needed to screen was 42 and 27 for subjects aged ≥65 and ≥75 years, respectively. The prescription rate of OACs significantly increased from 11.4 to 60.6% in Chiayi county and from 15.8 to 50.0% in Keelung City after screening (both p-values <0.001). CONCLUSION This community-based and government-endorsed AF screening project in Taiwan demonstrated that incorporation of AF screening into the preexistent adult health check programs through co-operations with the government was feasible. Actions to detect AF, good education, and well-organized transferring plan after AF being detected with the involvement of public health care systems could result in a substantial increase in the prescription rate of OACs.
Collapse
Affiliation(s)
- Tze-Fan Chao
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Clinical Medicine and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yung-Hsin Yeh
- The Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Yi-Hsin Chan
- The Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Microscopy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Fang-Ju Lin
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan
| | - Tien-Hsing Chen
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Cardiology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Kuo-Li Pan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan
| | - Jiunn-Cherng Lin
- Institute of Clinical Medicine and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Division of Cardiology, Taichung Veterans General Hospital, Chiayi branch, Chiayi, Taiwan
| | - Yenn-Jiang Lin
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Clinical Medicine and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Ann Chen
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Clinical Medicine and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan
| |
Collapse
|
6
|
Ding XF, Ding WX, Chen Y, Dai BL, Zhao YN, Duo-Duo Z, Yang YH, Gao LJ, Xia YL, Dong YX. Long duration of atrial high-rate episode is more favorable in predicting ischemic stroke than high CHA 2 DS 2 -VASc score. Pacing Clin Electrophysiol 2023; 46:1635-1642. [PMID: 37942981 DOI: 10.1111/pace.14857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2023] [Revised: 09/19/2023] [Accepted: 10/15/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVE This study aimed to explore the roles of duration and burden of atrial high-rate episode (AHRE) on ischemic stroke in patients with pacemaker implantation. METHODS Patients with pacemaker implantation for bradycardia from 2013 to 2017 were consecutively enrolled. Data such as gender, age, combined diseases, type of AF, left atrial size, left ventricular size, left ventricular ejection fraction, CHA2 DS2 -VASc score, and anticoagulants were collected. The burden and duration of AHRE based on different interval partition were also recorded in detail to evaluate the impacts on ischemic stroke. Cox regression analysis with time-dependent covariates was conducted. RESULTS A total of 220 patients with AHRE were enrolled. The average follow-up time was 48.42 ± 17.20 months. Univariate regression analysis showed that diabetes (p = .024), high CHA2 DS2 -VASc score (≥ 2) (p = .021), long mean AHRE burden (p = .011), long maximal AHRE burden (p = .015), long AHRE duration lasting≥48 h (p = .001) or 24 h (p = .001) or 12 h (p = .005) were prone to ischemic stroke. Further multivariate regression analysis showed that long duration of AHRE (≥48 h) (HR 10.77; 95% CI 3.22-55.12; p = .030) were significantly correlated with stroke in patients with paroxysmal AF. There was no significant correlation between the type of AF and stroke (p = .927). CONCLUSION The longer duration of AHRE (≥48 h) was more favorable in predicting ischemic stroke than high CHA2 DS2 -VASc score (≥2).
Collapse
Affiliation(s)
- Xue-Fang Ding
- First affiliated hospital of Dalian Medical University, Dalian, China
| | - Wan-Xuan Ding
- First affiliated hospital of Dalian Medical University, Dalian, China
| | - Ying Chen
- First affiliated hospital of Dalian Medical University, Dalian, China
| | - Bai-Ling Dai
- First affiliated hospital of Dalian Medical University, Dalian, China
| | - Yan-Ni Zhao
- First affiliated hospital of Dalian Medical University, Dalian, China
| | - Zhang Duo-Duo
- First affiliated hospital of Dalian Medical University, Dalian, China
| | - Yi-Heng Yang
- First affiliated hospital of Dalian Medical University, Dalian, China
| | - Lian-Jun Gao
- First affiliated hospital of Dalian Medical University, Dalian, China
| | - Yun-Long Xia
- First affiliated hospital of Dalian Medical University, Dalian, China
| | - Ying-Xue Dong
- First affiliated hospital of Dalian Medical University, Dalian, China
| |
Collapse
|
7
|
Shimizu W, Kusumoto FM, Agbayani MJF, Apiyasawat S, Chen M, Ching CK, Choi JI, Dan Do VB, Hanafy DA, Hurwitz JL, Johar S, Kalman JM, Khan AHH, Khmao P, Krahn AD, Ngarmukos T, Binh Nguyen ST, Nwe N, Oh S, Soejima K, Stiles MK, Tsao HM, Tseveendee S. Statement from the Asia Summit: Current state of arrhythmia care in Asia. Heart Rhythm O2 2023; 4:741-755. [PMID: 38034890 PMCID: PMC10685152 DOI: 10.1016/j.hroo.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 08/28/2023] [Indexed: 12/02/2023] Open
Abstract
On May 27, 2022, the Asia Pacific Heart Rhythm Society and the Heart Rhythm Society convened a meeting of leaders from different professional societies of healthcare providers committed to arrhythmia care from the Asia Pacific region. The overriding goals of the meeting were to discuss clinical and health policy issues that face each country for providing care for patients with electrophysiologic issues, share experiences and best practices, and discuss potential future solutions. Participants were asked to address a series of questions in preparation for the meeting. The format of the meeting was a series of individual country reports presented by the leaders from each of the professional societies followed by open discussion. The recorded presentations from the Asia Summit can be accessed at https://www.heartrhythm365.org/URL/asiasummit-22. Three major themes arose from the discussion. First, the major clinical problems faced by different countries vary. Although atrial fibrillation is common throughout the region, the most important issues also include more general issues such as hypertension, rheumatic heart disease, tobacco abuse, and management of potentially life-threatening problems such as sudden cardiac arrest or profound bradycardia. Second, there is significant variability in the access to advanced arrhythmia care throughout the region due to differences in workforce availability, resources, drug availability, and national health policies. Third, collaboration in the area already occurs between individual countries, but no systematic regional method for working together is present.
Collapse
Affiliation(s)
| | - Fred M. Kusumoto
- Mayo Clinic Jacksonville, EP and Pacing Services, Jacksonville, Florida
| | | | | | | | | | - Jong-Il Choi
- Korea University Medical Center, Seoul, Republic of Korea
| | - Van Buu Dan Do
- Tam Duc Cardiology Hospital Joint Stock Company, Ho Chi Minh City, Vietnam
| | | | | | | | | | | | | | - Andrew D. Krahn
- Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | - Nwe Nwe
- Yangon General Hospital, Yangon, Myanmar
| | - Seil Oh
- Seoul National University Hospital, Seoul, Republic of Korea
| | | | | | | | | |
Collapse
|
8
|
Yamin M, Salim S, Setiati S, Pudianto AP, Zulmiyusrini P, Nasution SA, Wijaya IP, Rusdi L, Karim B, Santoso RFH, Silitonga FAH. Validity and reliability studies of the Indonesian version of Atrial Fibrillation Severity Scale (AFSS). BMC Cardiovasc Disord 2023; 23:216. [PMID: 37118699 PMCID: PMC10148504 DOI: 10.1186/s12872-023-03240-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 04/12/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND In the atrial fibrillation (AF) population, worsened quality of life (QOL) has been reported even before complications occur. Symptom-based questionnaires can be used to evaluate AF treatment. The Atrial Fibrillation Severity Scale (AFSS) was first developed in Canada in English, which is not the main language in Indonesia. This study aims to test the reliability and validity of the Indonesian version of the Atrial Fibrillation Severity Scale (AFSS). METHODS Translation of the AFSS from English to Indonesian was done using forward and backward translation. The final version was then validated with the Short Form-36 (SF-36) questionnaire, and a test-retest reliability study was done in a 7-14-day interval. RESULTS An Indonesian version of AFSS was achieved and deemed acceptable by a panel of researchers. This version is reliable and valid, with Cronbach's α of 0.819, Intraclass Correlation Coefficient (ICC) ranging from 0.803 to 0.975, and total score correlation ranging from 0.333 to 0.895. Pearson's analysis of AFSS and SF-36 revealed that the total AF burden domain was poorly correlated with role limitations due to emotional problems (r:0.427; p < 0.01) and pain (r:0.495; p < 0.01). The symptom severity domain was poorly correlated with physical functioning (r:-0.335; p < 0.01), role limitations due to emotional problems (r:0.499; p < 0.01), pain (r:0.458; p < 0.01), and total SF-36 score (r:-0.361; p < 0.01). Total AFSS score was moderately correlated with role limitations due to emotional problems (r:0.516; p < 0.01) and pain (r:0.538; p < 0.01). The total AFSS score was poorly correlated with the European Heart Rhythm Association (EHRA) score (r:0.315; p < 0.01). CONCLUSION The Indonesian version of AFSS has good internal and external validity with good reliability.
Collapse
Affiliation(s)
- Muhammad Yamin
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jl. Pangeran Diponegoro No.71, Central Jakarta, Jakarta, Indonesia
| | - Simon Salim
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jl. Pangeran Diponegoro No.71, Central Jakarta, Jakarta, Indonesia.
| | - Siti Setiati
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Angga Pramudita Pudianto
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jl. Pangeran Diponegoro No.71, Central Jakarta, Jakarta, Indonesia
| | - Putri Zulmiyusrini
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - Sally Aman Nasution
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jl. Pangeran Diponegoro No.71, Central Jakarta, Jakarta, Indonesia
| | - Ika Prasetya Wijaya
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jl. Pangeran Diponegoro No.71, Central Jakarta, Jakarta, Indonesia
| | - Lusiani Rusdi
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jl. Pangeran Diponegoro No.71, Central Jakarta, Jakarta, Indonesia
| | - Birry Karim
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jl. Pangeran Diponegoro No.71, Central Jakarta, Jakarta, Indonesia
| | - Raden Fidiaji Hiltono Santoso
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jl. Pangeran Diponegoro No.71, Central Jakarta, Jakarta, Indonesia
| | - Friska Anggraini Helena Silitonga
- Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Hospital, Jl. Pangeran Diponegoro No.71, Central Jakarta, Jakarta, Indonesia
| |
Collapse
|
9
|
Whitfield R, Ascenção R, da Silva GL, Almeida AG, Pinto FJ, Caldeira D. Screening strategies for atrial fibrillation in the elderly population: a systematic review and network meta-analysis. Clin Res Cardiol 2022:10.1007/s00392-022-02117-9. [DOI: 10.1007/s00392-022-02117-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 10/11/2022] [Indexed: 11/09/2022]
|
10
|
Okumura Y. ABC Pathway. JACC: ASIA 2022; 2:430-432. [PMID: 36339356 PMCID: PMC9627967 DOI: 10.1016/j.jacasi.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|