Systematic and opportunistic screening for AF increase the rate of detection of new cases compared with routine practice .
While both approaches have a comparable effect on the overall AF diagnosis rate , the cost of systematic screening is significantly more than that of opportunistic screening from the perspective of the health service provider .
BACKGROUND Atrial fibrillation ( AF ) is the most common arrhythmia in clinical practice and is a leading cause of morbidity and mortality .
Screening for AF in asymptomatic patients has been proposed as a way of reducing the burden of the disease by detecting people who would benefit from prophylactic anticoagulation therapy prior to the onset of symptoms .
However , for screening to be an effective intervention it must improve the detection of AF and provide benefit for those who are detected earlier as a result of screening .
OBJECTIVES The primary objective of this review was to examine whether screening programmes increase the detection of new cases of AF compared to routine practice .
The secondary objectives were to identify which combination of screening strategy and patient population is most effective , as well as assessing any safety issues associated with screening , its acceptability within the target population and the costs involved .
Diagnostic yield of patient-activated loop recorders for detecting heart rhythm abnormalities in general practice: a randomised clinical trial.
BACKGROUND Because palpitations and light headedness often occur paroxysmally these complaints are difficult to diagnose . The hazards for a GP are too many diagnostic interventions for worried well and too few diagnostics for potentially life threatening complaints . OBJECTIVES Patient-activated memo event recorders have proved to be successful in diagnosing episodes of cardiac arrythmias in secondary care . We tested the diagnostic yield of these devices in general practice . METHODS A r and omized clinical trial in general practice . Consecutive patients with complaints of palpitations or light-headedness were r and omized to either usual care or usual care plus event-recorder . The main outcome was the difference in explained episodes . Secondary outcomes were the differences in the number and character of cardiac diagnoses and the feasibility of the event-recorder . RESULTS There were fewer patients without a diagnosis in the intervention group ( 17 % vs 38 % ; RR = 0.5 , 95 % CI 0.3 to 0.7 ) and more patients with a cardiac diagnosis ( 67 % vs. 27 % : RR 2.5 , CI 1.8 to 3,5 ) . More relevant cardiac arrhythmias were detected ( 22 % vs 7 % ) with event recording than with usual care ( RR 3.2 , 95 % CI 1.5 to 6.8 ) . CONCLUSION Patient-activated loop recorders are feasible and effective diagnostic tools in patients with palpitations or light-headedness in primary care . More research into patient characteristics and selection criteria is needed to fine-tune the use of these devices in primary care
Systematic and opportunistic screening for AF increase the rate of detection of new cases compared with routine practice .
While both approaches have a comparable effect on the overall AF diagnosis rate , the cost of systematic screening is significantly more than that of opportunistic screening from the perspective of the health service provider .
BACKGROUND Atrial fibrillation ( AF ) is the most common arrhythmia in clinical practice and is a leading cause of morbidity and mortality .
Screening for AF in asymptomatic patients has been proposed as a way of reducing the burden of the disease by detecting people who would benefit from prophylactic anticoagulation therapy prior to the onset of symptoms .
However , for screening to be an effective intervention it must improve the detection of AF and provide benefit for those who are detected earlier as a result of screening .
OBJECTIVES The primary objective of this review was to examine whether screening programmes increase the detection of new cases of AF compared to routine practice .
The secondary objectives were to identify which combination of screening strategy and patient population is most effective , as well as assessing any safety issues associated with screening , its acceptability within the target population and the costs involved .