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Published on: February 26, 2013
Prevalence of atrial fibrillation in adults participating in a large-scale voluntary screening programme in Belgium
Neree Claes1, Christophe Van Laethem, Marnix Goethals
1Faculty of Medicine, University Hasselt, Diepenbeek, Belgium. Neree.claes@uhasselt.be
Insights
A nationwide screening program in Belgium found atrial fibrillation (AF) in 2.2% of participants. This voluntary screening effectively identified many individuals with previously undetected AF, highlighting its potential for early intervention.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Atrial fibrillation (AF) is a prevalent clinical arrhythmia.
- AF meets criteria for screening programs, yet prevalence in non-hospitalized Belgian populations was unknown.
- A nationwide voluntary screening initiative was proposed to address this data gap.
Purpose of the Study:
- To assess the feasibility and effectiveness of a nationwide, voluntary screening program for atrial fibrillation (AF) in the general population of Belgium.
- To determine the prevalence of AF in a non-hospitalized Belgian cohort.
- To evaluate the utility of stroke risk stratification scores in identified AF cases.
Main Methods:
- Screened 13,564 participants, with 10,758 aged over 40 (GSP group).
- Administered stroke risk questionnaires (CHADS2 and CHA2DS2-VASc).
- Utilized a one-lead electrocardiogram for AF detection.
Main Results:
- Detected atrial fibrillation (AF) in 228 participants (2.2% prevalence; 95% CI 1.3%-3.0%).
- The AF group's average age was 67 ± 12 years.
- Based on CHADS2 and CHA2DS2-VASc scores, 58%-72% of AF patients had intermediate to high risk for thrombo-embolism.
Conclusions:
- The study identified a 2.2% prevalence of AF in the screened Belgian population.
- A significant proportion (at least 60%) of detected AF cases presented with an elevated risk for thrombo-embolism.
- Despite methodological limitations, the voluntary screening program demonstrated effectiveness in detecting a substantial number of previously undiagnosed AF cases.
Objective:
Atrial fibrillation (AF) is a common arrhythmia in clinical practice. AF fulfils many of the criteria for a screening programme. No data about the prevalence of AF in non-hospitalized patients are available in Belgium. The aim of the study was to assess feasibility and effectiveness of a nationwide-organized voluntary screening programme in the general population in Belgium.
Methods:
A total of 13.564 participants were screened, of whom 10,758 were older than 40 years (GSP group). Participants filled in stroke risk stratification questionnaires (CHADS2 and CHA2DS2-VASc). A one-lead electrocardiogram was performed.
Results:
228 participants had AF at the time of screening (AF group), with 125 women and 103 men (i.e., 1.9% and 2.6% of total women and men), representing a prevalence of 2.2% (95% CI 1.3% and 3.0%) of the screened population. Age of the AF group was 67 +/- 12 y (range 40-87 y). Using the CHADS2-score, 58% of participants with a positive AF screening had a high risk score, and 21% had an intermediate risk score. Using the CHA2DS2-VASc-score, 72% of the participants had a high risk score, and 21% had an intermediate risk score.
Conclusion:
AF was present in 2.2% of the respondents. At least 60% of AF group had an increased risk for thrombo-embolism. Although substantial methodological issues limit the exact interpretation of these results, the present study shows that a volunatry screening programme with a simple screening protocol is able to detect an important number of patients with previously undetected AF.
