The Methods Choice On Blood Pressure Measurement In Patients With Atrial Fibrillation

Objective:To assess the accuracy and stability of some measurement methods on blood pressure(BP)for patients with permanent atrial fibrillation.Methods:Between November 2016 to November 2018,a total of 208 patients with permanent atrial fibrillation are selected as the subjects.Blood pressure was m easured by different instrumentation,the instrumentation including intra-cavity ca theter,mercury sphygmomanometer,upper arm and wrist electronic sphygmomano meter.Measurement of sphygmomanometers were half an hour apart,each of whi ch was measured three times(each time interval is 1-2 min)for average.Unsta ble measurement was defined as systolic blood pressure(SBP)/diastolic blood pr essure(DBP)difference > 6 mm Hg in twice and above measurements.Bland-Al tman method was used to estimate the consistency of different sphygmomanom eters.Results:For all of the AF patients,the stability of intra-cavity catheter,mercury sp hygmomanometer,upper arm and wrist electronic sphygmomanometer measureme nts were 71.6%,49.5%,46.2% and 74.5%,respectively.Compared with blood pr essure value measured by intra-cavity catheter,SBP and DBP difference were s tatistically significant in mercury sphygmomanometer,upper arm and wrist electr onic sphygmomanometer groups(127/77,131/78,127/80 vs 133/83 mm Hg,all P<0.05).Consistency test showed the data of three kinds of non-invasive blood pressure measurement methods all have a deviate to the 0 reference line in dif ferent degree,the upper arm electronic sphygmomanometer(2.58 mm Hg)have the advantage on the measurement of SBP while the wrist electronic sphygmo manometer(2.57 mm Hg)have the advantage on the measurement of DBP,andthe differences were statistically significant(P<0.05).Conclusion:1.The values of systolic and diastolic blood pressure measured by three non-invasive blood pressure measurements are lower than those of intraaortic blood pressure.2.The upper arm electronic sphygmomanometer is closer to the intra-aortic blood pressure in the measurement of systolic blood pressure in patients with atrial fibrillation,and the wrist electronic sphygmomanometer is closer to the intra-aortic blood pressure in the measurement of diastolic blood pressure in patients with atrial fibrillation.In the measurement of systolic blood pressure,the distortion rate of upper arm electronic sphygmomanometer is the lowest,and that of wrist electronic sphygmomanometer is the lowest in the measurement of diastolic blood pressure.3.On the premise of setting 6 mmHg as a stable node,wrist-type electronic sphygmomanometer has the best stability in the process of blood pressure measurement and is higher than intraaortic blood pressure,while mercury sphygmomanometer and upper arm-type electronic sphygmomanometer have significantly lower stability in blood pressure measurement.