Atrial Fibrillation Detected by Single Time-Point Handheld Electrocardiogram Screening and the Risk of Ischemic...

Area of Science:

• Cardiology
• Geriatric Medicine
• Preventive Cardiology

Background:

• Atrial fibrillation (AF) is a common arrhythmia associated with increased stroke risk.
• Early detection of AF through screening may identify at-risk individuals who are not yet clinically diagnosed.
• The prognostic implications and optimal management of screen-detected AF require further investigation.

Purpose of the Study:

• To evaluate the stroke risk in patients with single time-point screen-detected atrial fibrillation (AF).
• To assess the impact of oral anticoagulant (OAC) therapy on stroke risk in patients with screen-detected AF.

Main Methods:

• Prospective enrollment of patients aged ≥65 years attending medical outpatient clinics.
• AF screening using handheld single-lead electrocardiogram (ECG).
• Comparison of stroke risk (ischemic stroke) between cohorts: screen-detected AF, clinically diagnosed AF, and no AF, stratified by OAC use.

Main Results:

• The yield of screen-detected AF on initial screening was 2.3%.
• Patients with screen-detected AF without OAC treatment had the highest stroke risk (aSHR: 2.63) compared to those without AF.
• Oral anticoagulant (OAC) use was associated with a significantly reduced risk of stroke in patients with screen-detected AF (p=0.01).

Conclusions:

• Single time-point ECG screen-detected AF is not benign and carries a substantial stroke risk.
• The findings support the use of OACs in patients with screen-detected AF to mitigate stroke risk.
• OAC therapy effectively reduces stroke incidence in this patient population.