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URL: https://dx.doi.org/DOI:10.17504/protocols.io.m2fc8bn

Authors: Faris Ghazal

Summary: BackgroundAtrial fibrillation (AF) is a major risk of ischemic stroke unless treated with anticoagulant. Detection of AF can be difficult because AF is often paroxysmal and asymptomatic. The aim of this study is to develop a screening model for detecting AF in a primary health care setting and to start oral anticoagulant therapy in high risk patients to prevent stroke.Methods and FindingsA cross-sectional study. All of 70- to 74-year-old individuals registered at a single primary health care centre in Stockholm were invited to AF screening upon visiting the centre during a ten-month period. Those who did not have contact with the centre during this period were invited to participate by letter. Intermittent ECG recording, 30 seconds twice a day, using a hand-held Zenicor device over a 2-week period, was offered to participants without AF. Oral anticoagulant therapy was offered to patients with newly detected AF.A total number of 324 (78.1%) out of 415 identified persons participated in the study. The mean age of the participants was 72 years, 52.2% were female and the median CHA2DS2-VASc was 3. Previously diagnosed AF was found in 34 (8.2%) persons in the target population. Among participants without previously known AF, 16 (5.5%) cases of new AF were detected. The final AF prevalence in the target population was 12%. Initiation of oral anticoagulant therapy was successful 88% of patients with newly detected AF.ConclusionsThe AF screening project showed a high participation rate and yielded a high rate of newly discovered AF of which 88% were able to be treated with oral anticoagulant.

Associated Publications: Feasibility and outcomes of atrial fibrillation screening using intermittent electrocardiography in a primary healthcare setting: A cross-sectional study

Affiliations: Karolinska Institute Stockholm

Version: 1

Publication Date: 2018

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