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Patient Directed Recording of a Bipolar Three-Lead Electrocardiogram using a Smartwatch with ECG Function
Published on: December 11, 2019
iPhone ECG screening by practice nurses and receptionists for atrial fibrillation in general practice: the GP-SEARCH
Jessica Orchard1, Saul Benedict Freedman, Nicole Lowres
1BEc/LLB (Hons I), MPH, Senior Project Officer, Cardiovascular Division, The George Institute for Global Health; and Adjunct Lecturer, Sydney Medical School, University of Sydney, NSW.
Background:
Atrial fibrillation (AF) is often asymptomatic and substantially increases stroke risk. A single-lead iPhone electrocardiograph (iECG) with a validated AF algorithm could make systematic AF screening feasible in general practice.
Methods:
A qualitative screening pilot study was conducted in three practices. Receptionists and practice nurses screened patients aged ≥65 years using an iECG (transmitted to a secure website) and general practitioner (GP) review was then provided during the patient's consultation. Fourteen semi-structured interviews with GPs, nurses, receptionists and patients were audio-recorded, transcribed and analysed thematically.
Results:
Eighty-eight patients (51% male; mean age 74.8 ± 8.8 years) were screened: 17 patients (19%) were in AF (all previously diagnosed). The iECG was well accepted by GPs, nurses and patients. Receptionists were reluctant, whereas nurses were confident in using the device, explaining and providing screening.
Discussion:
AF screening in general practice is feasible. A promising model is likely to be one delivered by a practice nurse, but depends on relevant contextual factors for each practice.
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