Routine pulse checking in older patients can lead to a substantial increase in the detection of atrial fibrillation, a major risk factor for stroke, according to a study in the British Medical Journal.
The study, conducted in England on nearly 15,000 patients ages 65 and over, compared active screening for atrial fibrillation — in which practice nurses either measured the patients' radial pulses to determine the need for follow-up electrocardiography or simply offered all patients electrocardiography — versus routine care during office visits.
The annual detection rate of new cases was 1.63% during active screening, compared with 1.04% in control practices.
The detection rate for active screening was nearly identical regardless of whether patients were offered electrocardiography routinely or only if they had an irregular pulse.
The authors concluded that routine electrocardiography is unnecessary for finding atrial fibrillation "as long as healthcare professionals are conscientious about feeling the pulse."
Link: BMJ article (Free)
Published in Physician's First Watch August 6, 2007