Opportunistic Screening for Atrial Fibrillation in the Pharmacies: A Population-Based Cross-Sectional Study

Area of Science:

• Cardiology
• Public Health
• Pharmacology

Background:

• Opportunistic screening for atrial fibrillation (AF) is crucial for identifying asymptomatic individuals.
• Early detection of AF can significantly reduce the incidence of ischemic stroke.

Purpose of the Study:

• To assess the feasibility of large-scale atrial fibrillation screening using a validated blood pressure monitor (MicrolifeAFIB).
• To evaluate the MicrolifeAFIB device's algorithm for detecting AF through heart rate variability analysis.

Main Methods:

• A cross-sectional study involving 3071 participants aged 50+ across 74 pharmacies.
• Data collection included demographics, cardiovascular history, medication use, blood pressure, and cardiac rhythm via MicrolifeAFIB.
• Individuals testing positive for AF were referred to their family doctor.

Main Results:

• The screening identified 98 participants (3.2%) with atrial fibrillation.
• Among those positive for AF, 44 had a prior diagnosis and were on anticoagulant or antiplatelet therapy.
• Age, male sex, and heart failure were independently associated with AF positivity. 9% of newly diagnosed AF cases had a history of stroke/TIA.

Conclusions:

• Pharmacy-based opportunistic screening for atrial fibrillation is feasible and effective.
• This screening strategy can identify individuals with undiagnosed, silent AF.
• Large-scale implementation holds potential for preventing cardiovascular morbidity and mortality.