Intended for healthcare professionals

Rapid response to:


Accuracy of diagnosing atrial fibrillation on electrocardiogram by primary care practitioners and interpretative diagnostic software: analysis of data from screening for atrial fibrillation in the elderly (SAFE) trial

BMJ 2007; 335 doi: (Published 23 August 2007) Cite this as: BMJ 2007;335:380

Rapid Response:

Are ECGs with interpretative software and electronic sphygomomanometers deskilling GPs in detecting Atrial Fibrillation?

With compliments to Dr Mant and his collaborators on their excellent study in accuracy of primary care staff diagnosing Atrial Fibrillation on ECG. I have a suspicion that GPs may have been deskilled in interpreting ECG since ECGs with interpretative software has been introduced into practices creating over reliance on the software result rather than reviewing the ECG "blind" before comparison .

I am also concerned that since the widespread use of electronic sphygmomanometers GPs may no longer be feeling the pulse routinely when taking blood pressures and may miss an irregular pulse. It remains important that the pulse is always taken when taking an electronic sphygmomanometer BP reading as the presence of an irregular rhythm may make the reading inaccurate 1.

1.Stewart MJ, Gough K and Padfield PL. The accuracy of automated blood pressure measuring devices in patients with controlled atrial fibrillation. Hypertens. 1995 Mar;13(3):297-300

Competing interests:
None declared

Competing interests: No competing interests

28 August 2007
Matt Hoghton
Clevedon Medical Centre, Old Street Clevedon BS21 6DG