Conclusions and Relevance Although screening with ECG can detect previously unknown cases of atrial fibrillation , it has not been shown to detect more cases than screening focused on pulse palpation .
Treatments for atrial fibrillation reduce the risk of stroke and all-cause mortality and increase the risk of bleeding , but trials have not assessed whether treatment of screen-detected asymptomatic older adults results in better health outcomes than treatment after detection by usual care or after symptoms develop
Importance Atrial fibrillation is the most common arrhythmia and increases the risk of stroke .
Objective To review the evidence on screening for nonvalvular atrial fibrillation with electrocardiography ( ECG ) and stroke prevention treatment in asymptomatic adults 65 years or older to inform the US Preventive Services Task Force .
EARLY: a pilot study on early diagnosis of atrial fibrillation in a primary healthcare centre.
AIM Atrial fibrillation ( AF ) is associated with high morbidity and mortality . Early diagnosis is likely to improve therapy and prognosis . The study objective was to evaluate the usefulness of a programme for early diagnosis of AF in patients from an urban primary care centre . METHODS AND RESULTS Participants were recruited from a r and omized sample of patients not diagnosed with AF but having relevant risk factors : age ≥ 65 years , ischaemic and /or valvular heart disease , congestive heart failure , hypertension , and /or diabetes . Patients were r and omly assigned to the intervention group ( IG ) or control group ( CG ) . The intervention included ( i ) initial visit with clinical history , electrocardiogram , and instruction about pulse palpation and warning signs and ( ii ) electrocardiogram every 6 months during a 2-year follow-up . The main endpoint of the study was the proportion of new cases diagnosed at 6 months . Secondary endpoints were number of new AF diagnoses and complications associated with the arrhythmia in both groups . A total of 928 patients were included ( 463 IG and 465 CG ) . At 6 months , AF was diagnosed in 8 IG patients and 1 CG patient ( 1.7 vs. 0.2 % , respectively , P = 0.018 ) . After 2 years of follow-up , 11 IG patients and 6 CG patients had newly diagnosed AF ( 2.5 vs. 1.3 % , respectively , P = 0.132 ) . Time to first diagnosis of AF was shorter in IG patients [ median ( inter-quartile range ) : 7 ( 192 ) days vs. 227 ( 188.5 ) days in CG , P = 0.029 ] . CONCLUSION The simple screening proposed could be useful for the early detection of AF in primary care
Conclusions and Relevance Although screening with ECG can detect previously unknown cases of atrial fibrillation , it has not been shown to detect more cases than screening focused on pulse palpation .
Treatments for atrial fibrillation reduce the risk of stroke and all-cause mortality and increase the risk of bleeding , but trials have not assessed whether treatment of screen-detected asymptomatic older adults results in better health outcomes than treatment after detection by usual care or after symptoms develop
Importance Atrial fibrillation is the most common arrhythmia and increases the risk of stroke .
Objective To review the evidence on screening for nonvalvular atrial fibrillation with electrocardiography ( ECG ) and stroke prevention treatment in asymptomatic adults 65 years or older to inform the US Preventive Services Task Force .