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20-01-2013 | Cardiology | Article

NICE recommends BP monitor for atrial fibrillation detection

Abstract

NICE guidance

medwireNews: The UK National Institute for Health and Clinical Excellence (NICE) has issued recommendations for the use of a new blood pressure (BP) device that could detect atrial fibrillation (AF).

The new guidance states that using the WatchBP Home A (Microlife Corporation, Switzerland) device could increase the detection rate of AF, which would allow preventative treatment to be given to reduce the incidence of AF-related stroke.

Watch BP Home A is an oscillometric BP monitor with an embedded algorithm, which automatically detects pulse irregularities that could be caused by symptomatic or asymptomatic AF.

Carole Longson, Director of the NICE Centre for Health Technology Evaluation, emphasizes that the new guidance is not about screening for AF, but instead focuses on the advantages of WatchBP Home A in detecting AF in people with suspected hypertension or those being screened for hypertension in primary care.

Jonathan Mant, Professor of Primary Care Research at the University of Cambridge, UK, told medwireNews: "It means that AF will automatically be screened for whenever BP is taken, which is a sensible idea, since in general one will be taking BP more often in the sort of people who are more likely to develop AF."

The guidance estimates that the overall cost saving per person screened will be between £2.98 (€ 3.58; US$ 4.74) and £4.26 (€ 5.11; US$ 6.82) for individuals aged 65 years or over, depending on age.

Mant explained that the WatchBP Home A monitor itself costs approximately £70-80 (€ 83.99-95.99; € 112.10-128.12), which he said "will not be prohibitive" to general practices.

Although the device manufacturer says that it is suitable for home use, the NICE recommendations state that evidence shows it is most appropriate for clinic use, and should not replace ambulatory monitoring.

The guidance also recommends that individuals with suspected AF on screening with the BP device should undergo an electrocardiogram (ECG) to confirm diagnosis, in line with the current NICE guidelines on AF. Mant explained that, because the BP device is a more accurate test than current practice, which uses pulse palpation, it will result in fewer unnecessary ECGs.

"This is a good strategy, which is likely to pick up more cases of undiagnosed AF than pulse palpation, and fewer false positives. This will prevent strokes, since AF is an important cause of stroke, and the risk of stroke can be substantially reduced by anticoagulation," he said.

By Piriya Mahendra, medwireNews Reporter

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