Atrial Fibrillation (AF) increases the risk of stroke. ^[1]. Approximately 40% of AF patients have no symptoms ^[2], leading to many being diagnosed by coincidence when hospitalized for other reasons ^[3], including stroke ^{[4, 5]}.

Who is affected?
AF is the most common sustained cardiac arrhythmia occurring in 5% of the population of 65 years and older and in 14% older than 85 years ^[6]. AF leads to a 5-fold higher risk of stroke and is responsible for 20% of all strokes ^[7]. Many people have no symptoms from AF and, therefore, remain undiagnosed. Early detection of AF followed by adequate treatment can reduce the risk of a stroke by 68% ^[8].

What is Atrial Fibrillation (AF)?
In AF, the heart chambers beat chaotically and irregularly. This irregularity can cause blood to pool in the atria, leading to clot formation. These blood clots may pass through the bloodstream to the brain, where they can block blood vessels and cause a stroke. The dangerous aspect of AF is that approximately 70% of episodes are asymptomatic and, therefore, often remain undiagnosed. Additionally, in its early stages, AF typically occurs sporadically, making it difficult to detect even during occasional doctor visits. The following risk factors further increase the risk of developing AF:^[9]

• Age
• Hypertension
• Diabetes
• Cardiovascular diseases
• Stress
• Smoking
• Alcohol
• Obesity

Microlife blood pressure monitors with implemented AFIB technology, enable patients to be screened for AF during blood pressure measurements at home, using a sophisticated algorithm. If AF is detected during blood pressure measurements, the AFIB symbol is displayed. While the Microlife AFIB technology does not provide a diagnosis, it offers important information for your doctor, who can refer you for a 12-lead ECG to confirm the presence of AF.

MAM (Microlife Average Mode) - Three automated sequential measurements for the best results

A systematic review of all clinical evidence on the Microlife AFIB detector^[10] demonstrated that the highest sensitivity and specificity are achieved with three sequential measurements. For this reason, Microlife blood pressure monitors with AFIB technology are designed to take three automatic blood pressure measurements.

Microlife AFIBsens: tested and clinically proven for detecting atrial fibrillation
Microlife AFIBsens detects AF with high accuracy (sensitivity 98%, specificity 92%)^[10] as demonstrated in multiple comparative studies with ECG. It can be used as a reliable screening test for early diagnosis.

All studies were compared against 12-lead ECG unless otherwise indicated; n.s. indicates not specified; *compared against electrocardiographic diagram

Oxford trial 2013^[15]
The University of Oxford in the UK, known as one of the best medical universities in the world, has performed a randomized clinical trial among 1,000 GP patients to reveal the best method for AF screening in primary care. This study showed that using the Microlife WatchBP Home A is the best method and is recommended for AF screening in primary care practice and for patients at home.

“Conclusions: WatchBP performs better as a triage test for identifying AF in primary care than the single-lead ECG monitors as it does not require expertise for interpretation and its diagnostic performance is comparable to single-lead ECG analysis by cardiologists. It could be used opportunistically to screen elderly patients for undiagnosed AF at regular intervals and/or during BP measurement. ” 

Irregular heartbeat feature (IHB) – what is the difference with AFIBsens technology?

“The main purpose of the IHB detector, therefore, is not to diagnose arrhythmias but rather to serve as a warning message indicating that the BP reading may not be accurate because of the presence of arrhythmia ^{[10, 20]}“

The majority of the available blood pressure devices allow blood pressure measurements to be applied simultaneously to irregular heartbeats and arrhythmias. However, this does not distinguish between the different types of arrhythmias. If the IHB  symbol appears in the display, non-hazardous arrhythmias such as sinus arrhythmia, premature atrial contractions (PAC) or bradycardia are also included. This can lead to patient insecurity.

Microlife AFIBsens is a medically proven technology for blood pressure devices that detects atrial fibrillation. The high degree of accuracy has been proven several times in clinical trials and has been recommended by international specialists and physicians.

Microlife AFIBsens in primary care

#1 Atrial fibrillation detection recommended by doctors ^[21]

The AF detection system has convincingly proven its accuracy and showed that it leads to increased detection of new patients with AF when used in general clinical practice.

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2. Boriani G, Laroche C, Diemberger I, Fantecchi E, Popescu MI, Rasmussen LH et al.: Asymptomatic atrial fibrillation: clinical correlates, management, and outcomes in the EORP-AF Pilot General Registry. Am J Med 2015; 128:509-518 e502.
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8. Ruff CT, Giugliano RP, Braunwald E, Hoffman EB, Deenadayalu N, Ezekowitz MD et al.: Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet 2014; 383:955-962.
9. Newell A, Haynes J, Smith R. Evaluation of asymptomatic atrial fibrillation. Am Fam Physician. 2012;86:6
10. Verberk WJ, Omboni S, Kollias A, Stergiou GS: Screening for atrial fibrillation with automated blood pressure measurement: Research evidence and practice recommendations. Int J Cardiol 2016; 203:465-473.
11. Wiesel J, Wiesel D, Suri R, Messineo FC: The use of a modified sphygmomanometer to detect atrial fibrillation in outpatients. Pacing Clin Electrophysiol 2004; 27:639-643.
12. Stergiou GS, Karpettas N, Protogerou A, Nasothimiou EG, Kyriakidis M: Diagnostic accuracy of a home blood pressure monitor to detect atrial fibrillation. J Hum Hypertens 2009; 23:654-658.
13. Wiesel J, Fitzig L, Herschman Y, Messineo FC: Detection of atrial fibrillation using a modified microlife blood pressure monitor. Am J Hypertens 2009; 22:848-852.
14. Wiesel J, Abraham S, Messineo FC: Screening for asymptomatic atrial fibrillation while monitoring the blood pressure at home: trial of regular versus irregular pulse for prevention of stroke (TRIPPS 2.0). Am J Cardiol 2013; 111:1598-1601.
15. Kearley K, Selwood M, Van den Bruel A, Thompson M, Mant D, Hobbs FR et al.: Triage tests for identifying atrial fibrillation in primary care: a diagnostic accuracy study comparing single-lead ECG and modified BP monitors. BMJ Open 2014; 4:e004565.
16. Wiesel J, Arbesfeld B, Schechter D: Comparison of the Microlife blood pressure monitor with the Omron blood pressure monitor for detecting atrial fibrillation. Am J Cardiol 2014; 114:1046-1048.
17. Gandolfo C, Balestrino M, Bruno C, Finocchi C, Reale N: Validation of a simple method for atrial fibrillation screening in patients with stroke. Neurol Sci 2015; 36:1675-1678.
18. Chan PH, Wong CK, Pun L, Wong YF, Wong MM, Chu DW et al.: Head-to-Head Comparison of the AliveCor Heart Monitor and Microlife WatchBP Office AFIB for Atrial Fibrillation Screening in a Primary Care Setting. Circulation 2017; 135:110-112.
19. Chan PH, Wong CK, Pun L, Wong YF, Wong MM, Chu DW et al.: Diagnostic performance of an automatic blood pressure measurement device, Microlife WatchBP Home A, for atrial fibrillation screening in a real-world primary care setting. BMJ Open 2017; 7:e013685.
20. Alpert BS, Quinn D, Gallick D: Oscillometric blood pressure: a review for clinicians. J Am Soc Hypertens 2014; 8:930-938.
21. NICE: WatchBP Home A for opportunistically detecting atrial fibrillation during diagnosis and monitoring of hypertension http://guidance.nice.org.uk/MTG13. 2013; Assessed 18 Aug. 2015.

* Microlife home blood pressure monitors with Microlife AFIBsens technology are not available in USA