We read with interest the excellent review article by Yarows et al1 on "Home Blood Pressure Monitoring" and welcome their recommendations for the use of home blood pressure devices in view of the widespread problem of high blood pressure, which affects 25% to 30% of population.
Home blood pressure monitoring is done using electronic devices, some of which are now fairly accurate, easy, and practical to use. However, we note that in Table 1 ("Errors in Measurement") of their review, the authors list atrial fibrillation (AF) as a "contraindication" to the use of automatic devices for blood pressure measurement. Atrial fibrillation is commonly associated with hypertension, and it is therefore important to measure blood pressure accurately in these patients. In addition, home blood pressure monitoring in these patients would be useful. Electronic blood pressure measurement devices, including ambulatory blood pressure monitoring (ABPM) devices, are increasingly being used in the assessment of hypertension, but patients with AF are usually excluded because the accuracy of these devices in this patient group has not been proven.