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Increasing the reach: optimizing screening for atrial fibrillation-the STROKESTOP III study
Mashroor Khan1, Michael Ingre1, Fredrik Carlstedt2
1Department of Medicine Huddinge, Karolinska Institutet, Karolinska University Hospital Huddinge, SE-141 86 Stockholm, Stockholm, Sweden.
Insights
Opportunistic screening for atrial fibrillation (AF) may increase participation compared to population screening. This study compares participation rates to improve early AF detection and prevent stroke.
Area of Science:
- Cardiology
- Public Health
- Preventive Medicine
Background:
- Atrial fibrillation (AF) is a common arrhythmia and a major risk factor for ischemic stroke.
- Undiagnosed AF, often asymptomatic, poses a significant public health challenge.
- Early detection and treatment of AF can prevent strokes and improve patient outcomes.
Purpose of the Study:
- To compare the participation rates of opportunistic screening versus population screening for atrial fibrillation.
- To determine if opportunistic screening is a more effective method for increasing AF screening participation.
- To inform strategies for improving early detection of AF in at-risk populations.
Main Methods:
- STROKESTOP III, a randomized prospective cohort study involving 2954 individuals aged 75-76.
- Comparison of population screening versus opportunistic screening methods across 16 primary care clinics.
- Use of handheld one-lead ECG devices for 30-second recordings, three times daily for two weeks.
Main Results:
- The study aims to determine the participation rate in opportunistic screening compared to population screening.
- Participants with detected AF will be referred for primary healthcare physician consultation and treatment.
- The primary objective is to evaluate the effectiveness of opportunistic screening in increasing participation.
Conclusions:
- The STROKESTOP III study will yield crucial data on screening method effectiveness for atrial fibrillation.
- Findings will guide the selection of optimal screening strategies to enhance participation.
- Improved participation in AF screening can lead to better stroke prevention and public health outcomes.
Aims:
Atrial fibrillation (AF) is the most common type of cardiac arrythmia and is an important risk factor for ischaemic stroke. Many cases of AF remain undiagnosed due to its paroxysmal, intermittent, and often asymptomatic nature. Early detection of AF through screening and initiation of treatment with oral anticoagulants can prevent stroke, increase life expectancy, and decrease the cost of healthcare for the society. However, participation has been low in previous AF screening studies employing population screening. The aim of this study is to determine whether opportunistic screening is a superior method to increase participation in comparison to population screening. We hypothesize that opportunistic screening will significantly increase participation.
Methods And Results:
In our study, STROKESTOP III, a randomized prospective cohort study, we compare two different methods of AF screening in high-risk individuals: population screening vs. opportunistic screening. Sixteen different primary clinics in Värmland, Sweden, serving 75-76-year-old individuals (n = 2954), will be randomized to either population screening or opportunistic screening. The individuals will be instructed to record electrocardiogram (ECG) for 30 s, 3 times daily for 2 weeks, using a handheld one-lead ECG device. Patients with detected AF will be referred to their primary healthcare physician and offered treatment. The main objective of the study is to determine the rate of participation in opportunistic screening in comparison to population screening.
Conclusions:
The STROKESTOP III study will provide valuable information on which screening method to use for improved participation in atrial fibrillation screening.
