Reliability of pulse palpation in the detection of atrial fibrillation in an elderly population
Open Access
- 3 July 2017
- journal article
- research article
- Published by Taylor & Francis Ltd in Scandinavian Journal of Primary Health Care
- Vol. 35 (3), 293-298
- https://doi.org/10.1080/02813432.2017.1358858
Abstract
Purpose: Atrial fibrillation (AF) may first present as an ischemic stroke. Pulse palpation is a potential screening method for asymptomatic AF. We aimed to assess the reliability of pulse palpation by the elderly in detecting AF. Materials and methods: After brief information and training session conducted by a nurse, 173 subjects aged ≥75 years were instructed to palpate their pulse regularly for a month. After this, their ability to distinguish sinus rhythm (SR), SR with premature ventricular contractions (PVC) and AF by pulse palpation was assessed using an anatomic human arm model programmable with various rhythms. A control group of 57 healthcare professionals received the same information but not the training. Subjects unable to find the pulse were excluded (25 (14.5%) of the elderly and none in the healthcare group). Results: The median age of the elderly subjects was 78.4 [3.9] years and 98 (56.6%) were women. There were no differences between the elderly and healthcare groups in detecting SR (97.3% vs. 96.5%) or SR with PVCs (74.3% vs. 71.4%), but the elderly subjects identified slow (81.8% vs. 56.1%) and fast AF (91.9% vs. 80.7%) significantly better than the healthcare group. The ability to recognize SR with PVCs by the elderly was independently predicted by previous pulse palpation experience, secondary or higher level of education and one-point increase in MMSE score, while identifying the other rhythms had no predictors. Conclusions: The elderly can learn to reliably distinguish a normal rhythm after education. Pulse self-palpation may be a useful low-cost method to screen for asymptomatic AF.Keywords
Funding Information
- Finnish Foundation for Cardiovascular Research
- Clinical Research Fund (EVO) of Turku University Hospital, Turku, Finland
This publication has 15 references indexed in Scilit:
- Self-detection of atrial fibrillation in an aged population: the LietoAF StudyEuropean Journal of Preventive Cardiology, 2013
- 2012 focused update of the ESC Guidelines for the management of atrial fibrillationEP Europace, 2012
- Screening versus routine practice in detection of atrial fibrillation in patients aged 65 or over: cluster randomised controlled trialBMJ, 2007
- Meta-analysis: Antithrombotic Therapy to Prevent Stroke in Patients Who Have Nonvalvular Atrial FibrillationAnnals of Internal Medicine, 2007
- Is pulse palpation helpful in detecting atrial fibrillation? A systematic review.2006
- Contribution of Atrial Fibrillation to Incidence and Outcome of Ischemic StrokeStroke, 2005
- Randomised trial of two approaches to screening for atrial fibrillation in UK general practice.2002
- Screening for atrial fibrillation in the community: A multicenter validation trialJournal of Stroke and Cerebrovascular Diseases, 1999
- Atrial fibrillation as an independent risk factor for stroke: the Framingham Study.Stroke, 1991
- Atrial Fibrillation: A Major Contributor to Stroke in the ElderlyArchives of Internal Medicine, 1987