Evidence suggests that systematic screening and opportunistic screening for AF increase the rate of detection of new cases compared with routine practice .
Although these approaches have comparable effects on the overall AF diagnosis rate , the cost of systematic screening is significantly greater than the cost of opportunistic screening from the perspective of the health service provider .
BACKGROUND Atrial fibrillation ( AF ) , the most common arrhythmia in clinical practice , 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 before the onset of symptoms .
However , for screening to be an effective intervention , it must improve the detection of AF and provide benefit for those detected earlier as a result of screening .
OBJECTIVES This review aims to answer the following questions .Does systematic screening increase the detection of AF compared with routine practice ?
Which combination of screening population , strategy and test is most effective for detecting AF compared with routine practice ?
What safety issues and adverse events may be associated with individual screening programmes ?
How acceptable is the intervention to the target population ?
What costs are associated with systematic screening for AF ?
RISK OF STROKE IN NON-RHEUMATIC ATRIAL FIBRILLATION
Estimates of the risk of stroke for men with non-rheumatic atrial fibrillation were obtained from two large cohort studies --the Whitehall Study of London Civil Servants and the British  Regional Heart Study . The first cohort provided an estimated relative risk of stroke of 6.9 compared with controls . This increased risk confirms that of the other prospect i ve estimate , 5.6 , found in the Framingham study . In the second cohort only one of the men at risk had a stroke , and the risk estimate did not differ significantly from unity . The absolute rates of stroke in both cohorts were lower than those reported in the Framingham study , implying a lesser potential benefit from preventive measures . These lower rates should be considered in the planning of trials . The risk of stroke was significantly associated with raised systolic or diastolic blood pressure but not with age or coronary heart disease
Evidence suggests that systematic screening and opportunistic screening for AF increase the rate of detection of new cases compared with routine practice .
Although these approaches have comparable effects on the overall AF diagnosis rate , the cost of systematic screening is significantly greater than the cost of opportunistic screening from the perspective of the health service provider .
BACKGROUND Atrial fibrillation ( AF ) , the most common arrhythmia in clinical practice , 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 before the onset of symptoms .
However , for screening to be an effective intervention , it must improve the detection of AF and provide benefit for those detected earlier as a result of screening .
OBJECTIVES This review aims to answer the following questions .Does systematic screening increase the detection of AF compared with routine practice ?
Which combination of screening population , strategy and test is most effective for detecting AF compared with routine practice ?
What safety issues and adverse events may be associated with individual screening programmes ?
How acceptable is the intervention to the target population ?
What costs are associated with systematic screening for AF ?