Virtanen R et al.: Self-detection of atrial fibrillation in an aged population: the LietoAF Study. Eur J Prev Cardiol (2014) 21(11):1437-42.
Von 205 Finnen im Alter ≥75 Jahren erlernten 139 (68%) die Puls-Selbstkontrolle. Signifikante Prädiktoren für den Lernerfolg waren ein hoher Mini-Mental State Examination score (>24) (OR 7.5, 95% CI 1.5-37.3, p = 0.014), PC-Benutzung zu Hause (OR 4.7, 95% CI 1.9-11.5, p = 0.001), Unabhängigkeit bei alltäglichen Aktivitäten (OR 4.2, 95% CI 1.4-13.6, p = 0.013) und niedrige Herzfrequenz (OR 1.04, 95% CI 1.0-1.08, p = 0.037). Die Puls-Selbstkontrolle führte nicht zur vermehrten Inanspruchnahme örtlicher Einrichtungen des Gesundheitswesens und beeinträchtigte die Lebensqualität nicht. Innerhalb eines Monats entdeckten vier Teilnehmer neues asymptomatisches Vorhhofflimmern.
Early detection of atrial fibrillation (AF) in older people is important because AF is often asymptomatic and its first manifestation may be a disabling stroke. The objective of the LietoAF Study is to assess the motivation and capability of older people to learn pulse palpation and continue regular pulse measurements, and whether this self-assessment is helpful in the detection of new AF.
DESIGN AND METHOD:
The LietoAF Study is an intervention study. A total of 205 people aged ≥75 years were randomly selected to participate in the programme where a trained nurse gave individual education on pulse palpation. At 1 month, the eligible participants came to the first follow-up visit to assess the success of pulse self-monitoring.
A total of 139 participants (68%) learned pulse palpation and performed regular measurements during the early follow-up period. The significant independent predictors for learning and motivation were high Mini-Mental State Examination score (>24) (OR 7.5, 95% CI 1.5-37.3, p = 0.014), computer use at home (OR 4.7, 95% CI 1.9-11.5, p = 0.001), independence at daily activities (OR 4.2, 95% CI 1.4-13.6, p = 0.013) and low heart rate (OR 1.04, 95% CI 1.0-1.08, p = 0.037). Education did not cause extra visits to local healthcare centres and did not affect quality of life. Four participants observed a new asymptomatic AF during the 1-month follow-up.
Active older people are motivated and seem to learn pulse palpation. Our early experience suggests that simple nurse-based education is effective and useful in the early detection of asymptomatic AF.