Research Priorities in Atrial Fibrillation Screening: A Report From a National Heart, Lung, and Blood Institute
Emelia J Benjamin1,2, Alan S Go3,4,5, Patrice Desvigne-Nickens6
1Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, MA (E.J.B.).
Insights
Early detection of atrial fibrillation (AF) is crucial to prevent serious complications like stroke. This report outlines research priorities for effective AF screening strategies and understanding the implications of early detection.
Area of Science:
- Cardiology
- Public Health
- Medical Research
Background:
- Clinically recognized atrial fibrillation (AF) increases the risk of severe complications, including stroke, heart failure, and death.
- AF often goes undetected until complications arise, highlighting the need for early detection strategies.
- Uncertainty exists regarding optimal screening methods and the implications of detecting undiagnosed AF.
Purpose of the Study:
- To summarize key research priorities for atrial fibrillation screening identified by a National Heart, Lung, and Blood Institute (NHLBI) virtual workshop.
- To address knowledge gaps concerning the most effective strategies for detecting undiagnosed AF.
- To inform and catalyze research aimed at improving the diagnosis and management of patients with undiagnosed AF.
Main Methods:
- A virtual workshop convened global experts to review current knowledge and identify critical research gaps in AF screening.
- Discussions focused on key areas including opportunistic screening, AF as a risk factor/marker, AF burden, trial designs, and post-stroke screening.
- The workshop aimed to establish priorities for innovative, resource-efficient, and clinically relevant AF screening research.
Main Results:
- Key research priorities were identified across five major areas related to AF screening.
- The report emphasizes the need to clarify the role of opportunistic screening and AF's status as a risk factor or marker.
- Priorities include understanding the relationship between AF burden and outcomes, designing effective randomized trials, and evaluating screening post-stroke.
Conclusions:
- Further research is essential to establish optimal strategies for screening and managing undiagnosed atrial fibrillation.
- Prioritizing research in identified areas will advance the diagnosis, management, and prognosis of individuals with AF.
- Innovative and diverse research approaches are needed to improve outcomes for patients with undiagnosed AF.
Abstract:
Clinically recognized atrial fibrillation (AF) is associated with higher risk of complications, including ischemic stroke, cognitive decline, heart failure, myocardial infarction, and death. It is increasingly recognized that AF frequently is undetected until complications such as stroke or heart failure occur. Hence, the public and clinicians have an intense interest in detecting AF earlier. However, the most appropriate strategies to detect undiagnosed AF (sometimes referred to as subclinical AF) and the prognostic and therapeutic implications of AF detected by screening are uncertain. Our report summarizes the National Heart, Lung, and Blood Institute's virtual workshop focused on identifying key research priorities related to AF screening. Global experts reviewed major knowledge gaps and identified critical research priorities in the following areas: (1) role of opportunistic screening; (2) AF as a risk factor, risk marker, or both; (3) relationship between AF burden detected with long-term monitoring and outcomes/treatments; (4) designs of potential randomized trials of systematic AF screening with clinically relevant outcomes; and (5) role of AF screening after ischemic stroke. Our report aims to inform and catalyze AF screening research that will advance innovative, resource-efficient, and clinically relevant studies in diverse populations to improve the diagnosis, management, and prognosis of patients with undiagnosed AF.
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