Related Experiment Video
Updated: May 14, 2026
28:13
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Stepwise screening of atrial fibrillation in a 75-year-old population: implications for stroke prevention
Johan Engdahl1, Lisbeth Andersson, Maria Mirskaya
1Department of Medicine, Hallands Hospital Halmstad, Sweden. johan.engdahl@regionhalland.se
Circulation
|January 25, 2013
Summary
Screening for undiagnosed atrial fibrillation (AF) in 75-year-olds identified 9% needing anticoagulation. This stepwise approach effectively finds candidates for stroke prevention treatment.
Area of Science:
- Cardiology
- Public Health
- Geriatrics
Background:
- Atrial fibrillation (AF) is a common cause of stroke via cardiac emboli.
- Undiagnosed AF poses a significant risk as it is often asymptomatic.
- Screening for silent AF in at-risk populations is logical but lacks data on yield and cost-effectiveness.
Purpose of the Study:
- To evaluate the yield of a stepwise screening program for AF in elderly individuals.
- To identify candidates for oral anticoagulation therapy.
Main Methods:
- A stepwise screening program was implemented for 75- to 76-year-olds in Halmstad, Sweden.
- Participants underwent a 12-lead ECG and risk factor assessment.
- Individuals without diagnosed AF but with risk factors used a hand-held ECG for 2 weeks.
Main Results:
- Out of 848 participants, 10 (1%) had previously undiagnosed silent AF detected by 12-lead ECG.
- Among those with risk factors, 30 (7.4%) were diagnosed with paroxysmal AF using hand-held ECG.
- Overall, 75 participants (9%) were identified as candidates for oral anticoagulation.
Conclusions:
- A stepwise, risk-stratified screening for AF in 75-year-olds is effective.
- The screening identifies a substantial number of individuals indicated for oral anticoagulation therapy, aiding stroke prevention.
Related Concept Videos
01:26Coronary Artery Disease IV: Preventive Measures
Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
01:30Dysrhythmias V: Evaluating Dysrhythmias
Dysrhythmias, also known as arrhythmias, are disturbances in the heart's rhythm that range from benign to life-threatening. A thorough evaluation is crucial for appropriate management and involves a comprehensive medical history, physical examination, and various diagnostic tests.Medical HistorySymptoms: Collect detailed information on palpitations, dizziness, syncope, chest pain, and fatigue. Note their onset, frequency, and triggers.Previous Cardiac Issues: Document any history of heart...
01:27Pharmacodynamics in Geriatric Patients: Effects of Age
Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
01:25Dysrhythmias VI: Management of Dysrhythmias
Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
01:26Atherosclerosis III: Management
Management of atherosclerosis involves an integrated strategy encompassing pharmacological treatment, surgical interventions, lifestyle changes, and nutrition therapy to address the multifactorial nature of the disease.Pharmacological TherapyA cornerstone of atherosclerosis management is the use of pharmacological agents. Statins, such as atorvastatin, are pivotal in inhibiting HMG-CoA reductase, an enzyme that catalyzes an initial step in cholesterol synthesis in the liver. This reduction in...