Arrhythmias & electrophysiology
Reliability of single-lead electrocardiogram interpretation to detect atrial fibrillation: insights from the SAFER feasibility study
Authors' conclusion
Inter-rater reliability of AF diagnosis from single-lead ECGs was found to be moderate in older adults.
Study context
- Population
- Adults aged ≥65 years recording four single-lead electrocardiograms (ECGs) per day for 1–4 weeks with a handheld ECG recorder185 reviewed by both cardiologists
- Participants
- 2,141 adults
- Primary endpoint
- Inter-rater reliability of AF diagnosis by two independent cardiologists (linear weighted Cohen's kappa, κw)
Methodological detailssecondary analysis of the SAFER feasibility study, population-based atrial fibrillation (AF) screening study, ECGs with possible AF identified by a nurse aided by an automated algorithm, then reviewed by two independent cardiologists
- Secondary analysis of the SAFER feasibility study
- Population-based AF screening study
- ECGs with possible AF identified by a nurse aided by an automated algorithm, then reviewed by two independent cardiologists
Primary result
As reported in the abstract
Agreement on AF diagnosis (κw)
Participant level κw (95% CI 0.37-0.58); moderate
0.48
ECG level κw (95% CI 0.53-0.62); moderate
0.58
Further findings
Factors associated with agreement
- Participant level: agreement associated with number of adequate-quality ECGs, higher with ≥67 adequate-quality ECGs
- ECG level: agreement associated with ECG quality and algorithm-identified possible AF
Original publication
Reliability of single-lead electrocardiogram interpretation to detect atrial fibrillation: insights from the SAFER feasibility study. Europace. Published 28 June 2024. doi:10.
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