Screening of Diabetic and Heart Failure Patients for Silent Atrial Fibrillation

Area of Science:

• Cardiology
• Public Health
• Medical Diagnostics

Background:

• Atrial fibrillation (AF) is a prevalent heart rhythm disorder, often asymptomatic (silent AF).
• Undiagnosed AF in high-risk patients increases stroke risk, necessitating effective screening strategies.
• Targeting screening efforts toward high-risk populations can enhance efficiency.

Purpose of the Study:

• To investigate the prevalence of silent AF in individuals aged 65 and older with type 2 diabetes mellitus (DM2) or congestive heart failure (CHF).
• To evaluate the utility of intermittent handheld ECG screening in identifying previously undetected AF in this demographic.

Main Methods:

• A multicenter, observational, prospective cohort study involving 645 patients with DM2 or CHF.
• Intermittent ECG recordings using a handheld device (4 times daily for 2 weeks) were employed for screening.
• AF diagnosis required at least one 30-second recording of the arrhythmia; patients with <40 recordings were excluded.

Main Results:

• Previously undetected AF was diagnosed in 3.3% of patients with DM2 and CHF.
• A higher prevalence of 5.5% was observed in patients older than 74 years.
• Overall, AF was detected in approximately 1 in 30 patients within the high-risk cohort.

Conclusions:

• Intermittent handheld ECG screening is effective in identifying silent AF in high-risk populations.
• The prevalence of AF is notably higher in elderly patients within this high-risk group.
• These findings support targeted screening for silent AF in older individuals with DM2 or CHF.