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 .
PLACEBO-CONTROLLED, RANDOMISED TRIAL OF WARFARIN AND ASPIRIN FOR PREVENTION OF THROMBOEMBOLIC COMPLICATIONS IN CHRONIC ATRIAL FIBRILLATION: The Copenhagen AFASAK Study
From November , 1985 , to June , 1988 , 1007 out patients with chronic non-rheumatic atrial fibrillation ( AF ) entered a r and omised trial ; 335 received anticoagulation with warfarin openly , and in a double-blind study 336 received aspirin 75 mg once daily and 336 placebo . Each patient was followed up for 2 years or until termination of the trial . The primary endpoint was a thromboembolic complication ( stroke , transient cerebral ischaemic attack , or embolic complications to the viscera and extremities ) . The secondary endpoint was death . The incidence of thromboembolic complications and vascular mortality were significantly lower in the warfarin group than in the aspirin and placebo groups , which did not differ significantly . 5 patients on warfarin had thromboembolic complications compared with 20 patients on aspirin and 21 on placebo . 21 patients on warfarin were withdrawn because of non-fatal bleeding complications compared with 2 on aspirin and none on placebo . Thus , anticoagulation therapy with warfarin can be recommended to prevent thromboembolic complications in patients with chronic non-rheumatic AF
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 .