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 ?
Self-detection of atrial fibrillation in an aged population: the LietoAF Study
Background Early detection of atrial fibrillation ( AF ) in older people is important because AF is often asymptomatic and its first manifestation may be a disabling stroke . The objective of the LietoAF Study is to assess the motivation and capability of older people to learn pulse palpation and continue regular pulse measurements , and whether this self- assessment is helpful in the detection of new AF . Design and method The LietoAF Study is an intervention study . A total of 205 people aged ≥75 years were r and omly selected to participate in the programme where a trained nurse gave individual education on pulse palpation . At 1 month , the eligible participants came to the first follow-up visit to assess the success of pulse self-monitoring . Results A total of 139 participants ( 68 % ) learned pulse palpation and performed regular measurements during the early follow-up period . The significant independent predictors for learning and motivation were high Mini-Mental State Examination score ( > 24 ) ( OR 7.5 , 95 % CI 1.5–37.3 , p = 0.014 ) , computer use at home ( OR 4.7 , 95 % CI 1.9–11.5 , p = 0.001 ) , independence at daily activities ( OR 4.2 , 95 % CI 1.4–13.6 , p = 0.013 ) and low heart rate ( OR 1.04 , 95 % CI 1.0–1.08 , p = 0.037 ) . Education did not cause extra visits to local healthcare centres and did not affect quality of life . Four participants observed a new asymptomatic AF during the 1-month follow-up . Conclusion Active older people are motivated and seem to learn pulse palpation . Our early experience suggests that simple nurse-based education is effective and useful in the early detection of asymptomatic AF
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 ?