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Effectiveness of screening for atrial fibrillation and its determinants. A meta-analysis

Pawel Petryszyn1, Piotr Niewinski2, Aleksandra Staniak1

  • 1Department of Clinical Pharmacology, Wroclaw Medical University, Wroclaw, Poland.

Plos One
|March 21, 2019
PubMed

Insights

Screening for atrial fibrillation (AF) in adults aged 40 and older effectively detects new cases, aiding stroke prevention. Systematic screening and repeated rhythm assessments are more effective than opportunistic methods.

Area of Science:

  • Cardiology
  • Public Health
  • Preventive Medicine

Background:

  • Many patients with atrial fibrillation (AF) are undiagnosed, missing opportunities for crucial stroke prevention with oral anticoagulants.
  • Improved AF detection is essential for timely thromboprophylaxis.

Purpose of the Study:

  • To evaluate the effectiveness of atrial fibrillation screening versus no screening.
  • To compare the efficacy of various screening strategies for AF detection.

Main Methods:

  • A systematic review and meta-analysis of 25 studies (3 RCTs, 22 observational) involving 88,786 participants aged 40+.
  • Included studies utilized systematic or opportunistic screening with ECG or pulse palpation.
  • Extracted data focused on study characteristics and newly diagnosed AF incidence.

Main Results:

  • Screening detected previously undiagnosed AF in 1.5% of individuals.
  • Systematic screening (1.8%) was more effective than opportunistic screening (1.1%).
  • Repeated heart rhythm measurements (2.1%) yielded higher detection rates than single assessments (1.2%).

Conclusions:

  • Active screening for atrial fibrillation is effective in individuals aged 40 and above.
  • The organizational aspects of screening may be more critical than the specific technical tools used for rhythm assessment.
Abstract

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