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Diagnostic class | Technique | Sensitivity | Specificity | Automated analysis | Remote analysis | Cost | Advantages | Disadvantages |
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ECG rhythm monitoring | Continuous long-term ECG monitoring using implantable devices | High | High | + | + | High | High sensitivity and specificity | Costly, invasive equipment required |
Medium-term noninvasive ECG monitoring >24 hours | Moderate | High | +/− | +/− | Moderate | Moderate sensitivity and specificity | Patient inconvenience, some cases missed |
Short-term ECG monitoring -24 hours | Low | High | +/− | +/− | Low to moderate | Relatively inexpensive | Low diagnostic yield |
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Electrophysiological Biomarkers | Analysis of ECG indices, for example, P wave dispersion, QTc interval | Low to high | Moderate to high | − | − | Low | Cost-effective test already in routine clinical practice | Relatively labour intensive without automated analysis. Room for potential error |
Frequency of atrial premature beats on 24-hour Holter monitor | Moderate | Low-moderate | +/− | +/− | Low to moderate | Noninvasive test which the patient may already be undergoing | Low specificity |
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Molecular biomarkers | Proteins | Moderate to high | Moderate | + | − | Low | Mass screening possible | Relatively low specificity |
microRNAs | Expected to be equivalent to protein biomarkers |
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Morphological biomarkers | Echocardiography LA size | Low | Moderate | − | − | Moderate | Noninvasive test which the patient may already be undergoing. LA size is a standard measurement | Highly trained specialists and costly equipment required |
Echocardiography LA function, for example, myocardial tissue Doppler | High | Moderate | − | − | Moderate | Noninvasive test which the patient may already be undergoing | Highly trained specialists and costly equipment required. Potential room for error in patients with suboptimal image quality |
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