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 .
Prevalence of undiagnosed atrial fibrillation and of that not being treated with anticoagulant drugs: the AFABE study.
INTRODUCTION AND OBJECTIVES Atrial fibrillation constitutes a serious public health problem because it can lead to complications . Thus , the management of this arrhythmia must include not only its treatment , but antithrombotic therapy as well . The main goal is to determine the proportion of cases of undiagnosed atrial fibrillation and the proportion of patients not being treated with oral anticoagulants . METHODS A multicenter , population -based , retrospective , cross-sectional , observational study . In all , 1043 participants over 60 years of age were r and omly selected to undergo an electrocardiogram in a prearranged appointment .  Demographic data , CHA2DS2-VASc and HAS-BLED scores , international normalized ratio results , and reasons for not receiving oral anticoagulant therapy  were recorded . RESULTS The overall prevalence of atrial fibrillation was 10.9 % ( 95 % confidence interval , 9.1%-12.8 % ) , 20.1 % of which had not been diagnosed previously . In the group with known atrial fibrillation , 23.5 % of those with CHA2DS2-VASc≥2 were not receiving oral anticoagulant therapy , and 47.9 % had a HAS-BLED score≥3 . The odds ratio for not being treated with oral anticoagulation  was 2.04 ( 95 % confidence interval , 1.11 - 3.77 ) for women , 1.10 ( 95 % confidence interval , 1.05 - 1.15 ) for more advanced age at diagnosis , and 8.61 ( 95 % confidence interval 2.38 - 31.0 ) for a CHA2DS2-VASc score<2 . Cognitive impairment ( 15.2 % ) was the main reason for not receiving oral anticoagulant therapy . CONCLUSIONS The prevalence of previously undiagnosed atrial fibrillation in individuals over 60 years of age is 20.1 % , and 23.5 % of those who have been diagnosed receive no treatment with oral anticoagulants
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 .