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Accuracy of Physicians Interpreting Photoplethysmography and Electrocardiography Tracings to Detect Atrial Fibrillation: INTERPRET-AF

Aims: This study aims to compare the performance of physicians to detect atrial fibrillation (AF) based on photoplethysmography (PPG), single-lead ECG and 12-lead ECG, and to explore the incremental value of PPG presentation as a tachogram and Poincaré plot, and of algorithm classification for inter...

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Autores principales: Gruwez, Henri, Evens, Stijn, Proesmans, Tine, Duncker, David, Linz, Dominik, Heidbuchel, Hein, Manninger, Martin, Vandervoort, Pieter, Haemers, Peter, Pison, Laurent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8488290/
https://www.ncbi.nlm.nih.gov/pubmed/34616786
http://dx.doi.org/10.3389/fcvm.2021.734737
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author Gruwez, Henri
Evens, Stijn
Proesmans, Tine
Duncker, David
Linz, Dominik
Heidbuchel, Hein
Manninger, Martin
Vandervoort, Pieter
Haemers, Peter
Pison, Laurent
author_facet Gruwez, Henri
Evens, Stijn
Proesmans, Tine
Duncker, David
Linz, Dominik
Heidbuchel, Hein
Manninger, Martin
Vandervoort, Pieter
Haemers, Peter
Pison, Laurent
author_sort Gruwez, Henri
collection PubMed
description Aims: This study aims to compare the performance of physicians to detect atrial fibrillation (AF) based on photoplethysmography (PPG), single-lead ECG and 12-lead ECG, and to explore the incremental value of PPG presentation as a tachogram and Poincaré plot, and of algorithm classification for interpretation by physicians. Methods and Results: Email invitations to participate in an online survey were distributed among physicians to analyse almost simultaneously recorded PPG, single-lead ECG and 12-lead ECG traces from 30 patients (10 in sinus rhythm (SR), 10 in SR with ectopic beats and 10 in AF). The task was to classify the readings as ‘SR', ‘ectopic/missed beats', ‘AF', ‘flutter' or ‘unreadable'. Sixty-five physicians detected or excluded AF based on the raw PPG waveforms with 88.8% sensitivity and 86.3% specificity. Additional presentation of the tachogram plus Poincaré plot significantly increased sensitivity and specificity to 95.5% (P < 0.001) and 92.5% (P < 0.001), respectively. The algorithm information did not further increase the accuracy to detect AF (sensitivity 97.5%, P = 0.556; specificity 95.0%, P = 0.182). Physicians detected AF on single-lead ECG tracings with 91.2% sensitivity and 93.9% specificity. Diagnostic accuracy was also not optimal on full 12-lead ECGs (93.9 and 98.6%, respectively). Notably, there was no significant difference between the performance of PPG waveform plus tachogram and Poincaré, compared to a single-lead ECG to detect or exclude AF (sensitivity P = 0.672; specificity P = 0.536). Conclusion: Physicians can detect AF on a PPG output with equivalent accuracy compared to single-lead ECG, if the PPG waveforms are presented together with a tachogram and Poincaré plot and the quality of the recordings is high.
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spelling pubmed-84882902021-10-05 Accuracy of Physicians Interpreting Photoplethysmography and Electrocardiography Tracings to Detect Atrial Fibrillation: INTERPRET-AF Gruwez, Henri Evens, Stijn Proesmans, Tine Duncker, David Linz, Dominik Heidbuchel, Hein Manninger, Martin Vandervoort, Pieter Haemers, Peter Pison, Laurent Front Cardiovasc Med Cardiovascular Medicine Aims: This study aims to compare the performance of physicians to detect atrial fibrillation (AF) based on photoplethysmography (PPG), single-lead ECG and 12-lead ECG, and to explore the incremental value of PPG presentation as a tachogram and Poincaré plot, and of algorithm classification for interpretation by physicians. Methods and Results: Email invitations to participate in an online survey were distributed among physicians to analyse almost simultaneously recorded PPG, single-lead ECG and 12-lead ECG traces from 30 patients (10 in sinus rhythm (SR), 10 in SR with ectopic beats and 10 in AF). The task was to classify the readings as ‘SR', ‘ectopic/missed beats', ‘AF', ‘flutter' or ‘unreadable'. Sixty-five physicians detected or excluded AF based on the raw PPG waveforms with 88.8% sensitivity and 86.3% specificity. Additional presentation of the tachogram plus Poincaré plot significantly increased sensitivity and specificity to 95.5% (P < 0.001) and 92.5% (P < 0.001), respectively. The algorithm information did not further increase the accuracy to detect AF (sensitivity 97.5%, P = 0.556; specificity 95.0%, P = 0.182). Physicians detected AF on single-lead ECG tracings with 91.2% sensitivity and 93.9% specificity. Diagnostic accuracy was also not optimal on full 12-lead ECGs (93.9 and 98.6%, respectively). Notably, there was no significant difference between the performance of PPG waveform plus tachogram and Poincaré, compared to a single-lead ECG to detect or exclude AF (sensitivity P = 0.672; specificity P = 0.536). Conclusion: Physicians can detect AF on a PPG output with equivalent accuracy compared to single-lead ECG, if the PPG waveforms are presented together with a tachogram and Poincaré plot and the quality of the recordings is high. Frontiers Media S.A. 2021-09-20 /pmc/articles/PMC8488290/ /pubmed/34616786 http://dx.doi.org/10.3389/fcvm.2021.734737 Text en Copyright © 2021 Gruwez, Evens, Proesmans, Duncker, Linz, Heidbuchel, Manninger, Vandervoort, Haemers and Pison. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Gruwez, Henri
Evens, Stijn
Proesmans, Tine
Duncker, David
Linz, Dominik
Heidbuchel, Hein
Manninger, Martin
Vandervoort, Pieter
Haemers, Peter
Pison, Laurent
Accuracy of Physicians Interpreting Photoplethysmography and Electrocardiography Tracings to Detect Atrial Fibrillation: INTERPRET-AF
title Accuracy of Physicians Interpreting Photoplethysmography and Electrocardiography Tracings to Detect Atrial Fibrillation: INTERPRET-AF
title_full Accuracy of Physicians Interpreting Photoplethysmography and Electrocardiography Tracings to Detect Atrial Fibrillation: INTERPRET-AF
title_fullStr Accuracy of Physicians Interpreting Photoplethysmography and Electrocardiography Tracings to Detect Atrial Fibrillation: INTERPRET-AF
title_full_unstemmed Accuracy of Physicians Interpreting Photoplethysmography and Electrocardiography Tracings to Detect Atrial Fibrillation: INTERPRET-AF
title_short Accuracy of Physicians Interpreting Photoplethysmography and Electrocardiography Tracings to Detect Atrial Fibrillation: INTERPRET-AF
title_sort accuracy of physicians interpreting photoplethysmography and electrocardiography tracings to detect atrial fibrillation: interpret-af
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8488290/
https://www.ncbi.nlm.nih.gov/pubmed/34616786
http://dx.doi.org/10.3389/fcvm.2021.734737
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