***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background The aim of our study was to investigate the reliability of automated oscillometric blood pressure ( BP ) monitoring in the presence and absence of atrial fibrillation ( AF ) in hypertensive patients . Methods BP was measured and compared in 71 r and omly selected patients with AF and arterial hypertension diagnosis , 4 times each by auscultatory and oscillometric ( Microlife BP A6 PC with AF detection system )  methods . Results Study included 71 patients : 36 males ( mean age 67.4 years ) and 35 females ( 70.2 years ) . At the time of BP measuring procedure , 36 patients were in sinus rhythm ( SR ) and 35 in AF . In SR patients mean systolic blood pressure ( SBP ) was 132 ± 17.9 mmHg with auscultatory method ( AM ) , 137.4 ± 19.4 mmHg with oscillometric method ( OM ) ; mean diastolic BP was 77.1 ± 10.9 mmHg ( AM ) , 78.5 ± 12.2 mmHg ( OM ) , in AF patients mean SBP was 127.5 ± 15.1 mmHg ( AM ) , 133.6 ± 17.4 mmHg ( OM ) ; mean diastolic BP was 81.4 ± 9.9 mmHg ( AM ) , 83.5 ± 11.8 mmHg ( OM ) , p = 0.037 . The averages of differences for SBP and DBP in sinus rhythm group were ( −5.3 mmHg ( 95 % limits of agreement −27.2 – 16.6 ) ) and ( −1.4 mmHg ( 95 % limits of agreement −12.8 – 10.0 ) ) , respectively . In patients with AF the averages of differences for SBP and DBP were ( −6.1 mmHg ( 95 % limits of agreement −23.9 – 11.7 ) ) and ( −2.1 mmHg ( 95 % limits of agreement −12.9 – 8.7 ) ) , respectively . Conclusions The oscillometric device vali date d for patients with AF on average gives 5.3 mmHg higher systolic BP values for patients with SR and 6.3 mmHg higher BP values for patients with AF . However , the limits of agreement between two methods reveal wide range of r and om error rates which is a question able topic in clinical practice , as it could possibly affect the treatment of arterial hypertension in patients with AF Abstract Background : The use of automated ( oscillometric ) blood pressure ( BP ) devices is not vali date d in atrial fibrillation ( AF ) patients . Objectives : To assess the reliability of three oscillometric BP devices , and the agreement with invasive arterial blood pressure(IBP ) in AF patients . Methods : 48 AF patients with r and omized sequences of 10 consecutive BP measurements with two pairs of devices : ( 1 ) OmronR7 ™ (wrist ) and OmronHEM907 ™ (arm ) ; ( 2 ) OmronR7 ™ and Microlife WatchBPhome(arm ) . Reliability and agreement of each device were assessed by the intra-class correlation coefficient ( ICC ) for the continuous BP measurements and Bl and & Altman methodology , respectively . In 10 additional AF patients , 10 consecutive measurements with IBP and OmronHEM907 ™ , and IBP and Microlife WatchBPhome were performed . Results : The OmronR7 ™ was not able to obtain any BP Readings . Arm devices presented better ICC for systolicBP(SBP ) than for diastolicBP(DBP )  ( Omron HEM907 ™ :0.94 [ 0.90 ; 0.97 ] vs. 0.77 [ 0.67 ; 0.89 ] ; Microlife WatchBPhome:0.92 [ 0.88 ; 0.96 ] vs.0.79 [ 0.69 ; 0.89]).The correlation coefficient  between Microlife WatchBPhome and IBP computed using the average of repeated measurements from two to ten measurements improved up to the third and remained stable afterwards . The agreement between IBP and SBP , and IBP and DBP , was moderate as illustrated by a wide limit of agreement [ −24 ; 26](SBP ) and [−15;17](DBP ) for Microlife WatchBPHome , respectively and [ −30 ; 13](SBP ) and [ −7 ; 15](DBP ) for OmronHEM907 . Conclusions : BP measurement using the two arm oscillometric devices achieved a high reliability for SBP . The agreement between IBP and arm devices was low but using the average of three consecutive measurements improved the results substantially Objective To determine whether automated blood pressure measuring devices can measure blood pressure accurately in patients with atrial fibrillation . Design Comparison of the accuracy of two electronic sphygmomanometers [ Takeda UA-751 ( Takeda ) and Copal UA-251 ( Copal ) ] and two ambulatory blood pressure monitors [ Accutracker 1 ( Accutracker ) and SpaceLabs 90207 ( SpaceLabs ) ] with that of a trained observer using a Hawksley r and om-zero sphygmomanometer ( Hawksley ) , using the sequential same-arm technique . Setting University teaching hospital : medical wards and outpatient department . Subjects Twenty-eight patients , mean SD age 72 ± 9 years , blood pressure range 90–158/40–96 mmHg , in atrial fibrillation with a controlled ventricular rate . Main outcome measures The proportion of machine readings > 5 mmHg different from the Hawksley reading was compared with that obtained by three sequential Hawksley measurements . The variability of each measuring method was assessed by determining the SDD for the paired readings from each device . Results Five per cent of Takeda , 5 % of Copal , 14 % of Accutracker and 21 % of SpaceLabs readings could not be obtained . Sequential testing with the Hawksley result ed in an accuracy at the 5-mmHg level of ( systolic/diastolic ) 79/79 % , compared with 64/54 % ( P<0.05 for diastolic ) for the Takeda , 68/75 % ( NS ) for the Copal , 50/36 % ( P < 0.01 for both ) for the Accutracker and 50/29 % ( P < 0.01 for systolic , P < 0.001 for diastolic ) for the SpaceLabs . Intrapatient variability , as assessed by SDD , was 8.3/8.6 mmHg for the Hawksley , similar to that for the Copal ( 7.7/7.3 mmHg ) but higher for the Takeda ( 11.2/19.7 mmHg ) , the Accutracker ( 22.4/26.3 mmHg ) and the SpaceLabs ( 7.5/14.8 mmHg ) . Conclusions Accurate measurement of blood pressure with an electronic device is possible in patients who have atrial fibrillation ; the Copal UA-251 provides a satisfactory level of accuracy . However , the marked difference between devices and the limited accuracy of the other machines tested here demonstrates the need to ensure that such devices are of proven accuracy in this patient group Screening for  atrial fibrillation ( AF ) by assessing the pulse is recommended in high-risk patients . Some clinical trials demonstrated that the Microlife blood pressure monitor ( BPM ) with AF detection is more accurate than pulse palpation . This led to a change in practice guidelines in the United Kingdom where AF screening with the Microlife device is recommended instead of pulse palpation . Many BPMs have irregular heart beat detection , but they have not been shown to detect AF reliably . Recently , one study , in a highly select population , suggested that the Omron BPM with irregular heart beat detection has a higher sensitivity for AF than the Microlife BPM . We compared the Microlife and Omron BPMs to electrocardiographic readings for AF detection in general cardiology patients . Inclusion criteria were age≥50 years without a pacemaker or defibrillator . A total of 199 subjects were enrolled , 30 with AF . Each subject had a 12-lead electrocardiography , 1 Omron BPM reading , and 3 Microlife BPM readings as per device instructions . The Omron device had a sensitivity of 30 % ( 95 % confidence interval [ CI ] 15.4 % to 49.1 % ) with the sensitivity for the first Microlife reading of 97 % ( 95 % CI 81.4 % to 100 % ) and the Microlife readings using the majority rule ( AF positive if at least 2 of 3 individual readings were positive for AF ) of 100 % ( 95 % CI 85.9 % to 100 % ) . Specificity for the Omron device was 97 % ( 95 % CI 92.5 % to 99.2 % ) and for the first Microlife reading of 90 % ( 95 % CI 83.8 % to 94.2 % ) and for the majority rule Microlife device of 92 % ( 95 % CI 86.2 % to 95.7 % ; p<0.0001 ) . The specificity of both devices is acceptable , but only the Microlife BPM has a sensitivity value that is high enough to be used for AF screening in clinical practice Background and Research Objective : Limited research is available on the accuracy of automatic blood pressure  ( BP ) measurement devices in patients with irregular rhythms . The purpose of this study was to examine the agreement between different methods for noninvasive BP measurement in patients with atrial fibrillation . Subjects and Methods : In a convenience sample of hospitalized patients with atrial fibrillation , a method -comparison study design was used to examine the agreement between 2 noninvasive devices for BP measurement ( manual , automated ) . Blood pressure was obtained sequentially , with each device following manufacturer 's directions and American Heart Association guidelines for BP determination and with BP order determined by r and om assignment . Heart rate and rhythm were determined from a continuous electrocardiographic monitoring . Heart rate was also recorded from the automated BP device . Differences and limits of agreement between the automated and reference st and ard ( manual ) BP devices were calculated and graphed according to the Bl and -Altman method . Student t test was used to test differences in BP obtained with the 2 devices , as well as heart rate differences between the electrocardiographic monitor and automated BP device . The level of significance for all tests was set at 0.05 . Results : 53 participants were observed . Bl and -Altman analysis found a bias plus/minus precision of −0.91 ± 11.4 mm Hg for systolic BP and 3.3 ± 6.9 mm Hg for diastolic BP . A significant difference was found for the diastolic BP obtained with the automated device and with that of the manual device ( t52 = 3.51 , P = .0009 ) and for heart rate differences between the automated BP device and the cardiac monitor ( t52 = 2.4 , P = .0217 ) . Conclusion : This study confirms that in the presence of irregular cardiac rhythms , diastolic BP and heart rate can not reliably be measured with an automated BP device OBJECTIVE --To compare the interobserver and intraobserver variability of blood pressure  measurements in geriatric patients in atrial fibrillation and in sinus rhythm . DESIGN -- Prospect i ve assessment of  blood pressure measurements carried out in r and om order in two groups of elderly patients by five doctors unaware of the aims of the study . SETTING --Acute assessment wards for geriatric medicine , Cardiff Royal Infirmary . PATIENTS --50 Elderly patients in sinus rhythm and 50 in atrial fibrillation . MAIN OUTCOME MEASURES --Interobserver and intraobserver variability of blood pressure measurements in the two groups expressed as the coefficient of variability and compared by the Mann-Whitney  U test  . RESULTS --Interobserver variability was significantly greater in the patients with atrial fibrillation for both systolic and diastolic pressures . Intraobserver variability was significantly greater in the atrial fibrillation group for diastolic pressures but the difference was not significant for systolic pressures . These differences were not related to pulse rate , age , or level of blood pressure . CONCLUSIONS --The findings suggest that in the presence of atrial fibrillation physicians ' interpretations of Korotkoff sounds are less uniform , which may have important clinical implication s. Possibly a st and ardised methodology may overcome this problem Asymptomatic atrial fibrillation ( AF ) is a common cause of strokes . Physician screening for AF has been recommended . Home screening for AF may increase the likelihood of detecting asymptomatic AF in patients at risk for stroke because of AF . The aim of this study was to assess the feasibility and accuracy of screening for AF when taking home blood pressure ( BP ) measurements using an automatic AF-detecting BP monitor .  Subjects aged > 64 years or those with hypertension , diabetes , congestive heart failure , or previous stroke were enrolled by their primary physicians and given the AF-BP monitor and an electrocardiographic event monitor to use at home for 30 days . The AF-BP monitor reading was compared with the electrocardiographic reading to calculate the sensitivity and specificity of the device for detecting AF . A total of 160 subjects were enrolled , with 10 withdrawing , 1 excluded , and 10 with no AF-BP monitor logs or electrocardiographic recordings . Of the 139 subjects included , 14 had known AF . There was a total of 3,316 days with AF-BP monitor readings and electrocardiographic readings . On the basis of the initial daily AF-BP monitor readings , the AF-BP monitor 
    Output:
    
Devices with AF detection algorithms appeared no more accurate for BP measurement with AF than other devices .
A previous review concluded that oscillometric devices are accurate for systolic but not diastolic BP measurement in AF .
We found no evidence that devices with AF detection measure BP more accurately in AF than other devices .