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 .
Screening for atrial fibrillation in the community: a multicenter validation trial.
BACKGROUND Atrial fibrillation ( AF ) is an important public health problem . This arrhythmia is common and associated with a high risk of stroke . Further , appropriate interventions in AF can reduce the risk of stroke by approximately 68 % . Population studies show that a large group of patients have intermittent or chronic AF that remains unrecognized . If a simple screening test for this arrhythmia could be developed and vali date d , application of the technique across population s might identify AF patients for early treatment , potentially reducing the incidence of stroke . In this study , we sought to determine whether individuals taken from the general community could be taught to find and classify the pulse of another as very irregular , implying AF , or regular , implying normal sinus rhythm ( NSR ) . The aim was to establish that pulse examination for potential AF could be performed by individuals with sufficient sensitivity and specificity to be effectively used as a screening procedure for this medically important arrhythmia . METHODS We enrolled 178 subjects selected from the general community from four centers . Subjects received st and ardized education on the medical importance of AF and its signature , a very irregular pulse . A technique for palpating and characterizing the rhythm of the radial pulse was also taught . Without further coaching , subjects were then asked to find their pulse and then to find and classify the pulse of two models r and omly presented who may or may not have had AF . RESULTS Of the 178 subjects tested , 92 % were able to find their own pulse ; 17 ( 9.6 % ) were unable to find the pulse of one or both patient models and were , therefore , excluded from the study . Of the remaining 161 subjects , 76 % ( 122 of 161 ) correctly identified the pulse in an AF model , and 86 % ( 139 of 161 ) correctly identified the pulse in an NSR model . Results did not statistically differ as a function of age , educational status , or location . DISCUSSION This multicenter trial established that given minimal st and ardized instructions , subjects from the general community can reliably and consistently find both their pulse as well as the pulse of another and to differentiate a regular pulse from a very irregular pulse . If similar educational programs were widely applied across large population s , periodic screening for AF might lead to earlier diagnosis and appropriate treatment for patients who have this major risk factor for stroke . These screening programs should be focused on the population over the age of 55 where the risk of stroke in AF increases with each decade
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 .