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Screening for undiagnosed atrial fibrillation
Roopinder K Sandhu1, Jeff S Healey2
1a Department of Medicine, Division of Cardiology , Mazankowski Alberta Heart Institute, University of Alberta , Edmonton , Alberta , Canada.
Insights
Atrial fibrillation (AF) screening can identify asymptomatic cases early, potentially preventing strokes. Further research is needed to confirm its long-term benefits and optimize treatment pathways.
Area of Science:
- Cardiology
- Public Health
- Preventive Medicine
Background:
- Atrial fibrillation (AF) is a global health concern linked to high morbidity, mortality, and healthcare expenses.
- Many AF patients are asymptomatic, with stroke often being the initial diagnosis.
- Early detection through screening can prevent severe complications.
Purpose of the Study:
- To review the rationale and methods for AF screening.
- To evaluate AF as a condition suitable for population-level screening.
- To discuss the benefits, drawbacks, and future research needs for AF screening.
Main Methods:
- Literature review of AF screening methods, studies, and economic analyses.
- Evaluation of AF against established population screening criteria.
- Synthesis of expert commentary on current evidence and future directions.
Main Results:
- AF screening is generally simple, low-risk, and cost-effective.
- Existing studies support the potential of AF screening for early detection.
- Significant gaps remain in validating new technologies and confirming stroke reduction.
Conclusions:
- AF screening offers a promising strategy for early detection and prevention of AF-related complications.
- Further research is crucial to validate emerging screening technologies and anticoagulation strategies.
- Long-term studies are needed to definitively establish the impact of AF screening on stroke reduction and healthcare costs.
Introduction:
Atrial fibrillation (AF) is a condition of global importance, and it is associated with significant morbidity, mortality, and healthcare costs. A considerable proportion of patients with AF are asymptomatic, and stroke may be the first clinical manifestation of their AF diagnosis. AF screening provides an opportunity to identify patients with undetected AF prior to suffering a devastating complication. Areas covered: This review will provide a rationale for AF screening; summarize AF screening methods, studies, and economic analyses; evaluate AF as a condition meeting criteria for population screening; and discuss potential drawbacks. Expert commentary: While AF screening is simple, low risk, and, in most cases, low cost, additional research is needed validating new technologies and devices; defining strategies for linking screening with initiation of oral anticoagulation therapy and determining whether AF screening ultimately reduces stroke and stroke-related complications and costs.
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