Atrial fibrillation does not affect ankle–brachial index measured using the Doppler method

Abstract

Atrial fibrillation may affect blood pressure measurements. The ankle-brachial index (ABI) is a ratio of systolic blood pressure measured on the lower and upper limbs that may also be affected by arrhythmia. The purpose of the study was to investigate whether atrial fibrillation influenced ABI results. Ninety-nine patients (age 66.6±11 years, 63 males and 36 females) who underwent electrical cardioversion of atrial fibrillation were investigated. ABI measurements using the Doppler method were performed on both lower extremities before and after electrical cardioversion. Measurements were repeated three times and then averaged. The ABI using both lower limbs was lower before electrical cardioversion than after restoration to sinus rhythm (right side: 1.132 (1.065-1.210) during atrial fibrillation vs. 1.179 (1.080-1.242) in sinus rhythm, P=0.019; left side: 1.142 (1.075-1.222) during atrial fibrillation vs. 1.170 (1.098-1.255) in sinus rhythm, P=0.011). However, the upper 95% confidence interval (CI) margins for the median differences in ABI were 0.045 and 0.040 for right and left, respectively, suggesting that the observed difference was clinically insignificant. There was a significant correlation between measurements obtained before and after electrical cardioversion on both lower limbs (r=0.61, P<0.001 and r=0.67, P<0.001). The Bland-Altman plot showed good agreement between measurements performed using the Doppler method during atrial fibrillation and sinus rhythm. Study results showed that atrial fibrillation did not have a clinically important effect on ABI measurements.

Atrial fibrillation influences automatic oscillometric ankle-brachial index measurement

“…Atrial fibrillation may substantially influence blood pressure measurements. Previously, we found that the results of ABI measured using the Doppler method during atrial fibrillation corresponded with the results obtained in sinus rhythm [9].…”

“…In this study, we included data from one hundred and fifteen consecutive patients with atrial fibrillation admitted for electrical cardioversion (EC). The current study is the extension of the research published by Dabrowski et al [9], where detailed patients' characteristics were presented. Ninety-nine patients (mean age: 66.6 ±11) years, M/F − 63/36) underwent the complete study protocol and were analyzed ( Figure 1).…”

“…A sample size calculation was made for the initial study and presented in our previous publication [9]. Each lower extremity measurement was considered as a separate test; therefore, 198 measurements were repeated 3 times using both the Doppler and the oscillometric method.…”

“…Especially in patients with atrial fibrillation (AF), the ABI may be potentially more difficult because of high beat-to-beat variability of heart rate and stroke volume [8]. Our previous study showed that AF does not significantly affect ABI measured by the Doppler method [9]. However, there is still a lack of data indicating whether the automatic oscillometric method, often used for ABI measurements, is also accurate in AF patients.…”

Ankle Brachial Index Predicts for Difficulties in Performing Microvascular Anastomosis

“…1. Preoperative stage: the informed consent process was conducted, the ABI was measured using a handheld Doppler probe and calculated as previously described, 7 and the general anamnesis and routine laboratory values were taken. 2.…”