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Screening for atrial fibrillation in primary care
N M Wheeldon1, D I Tayler, E Anagnostou
1Cardiothoracic Unit, Northern General Hospital, Sheffield, UK.
Heart (British Cardiac Society)
|March 20, 1998
Summary
Screening elderly patients for atrial fibrillation revealed a high prevalence of the condition, with nearly half eligible for anticoagulation treatment. Current treatment rates are significantly lower, indicating a need to increase warfarin use in eligible individuals.
Area of Science:
- Cardiology
- Geriatrics
- Public Health
Background:
- Atrial fibrillation is a common arrhythmia in the elderly population.
- Effective anticoagulation significantly reduces stroke risk in patients with atrial fibrillation.
- Current anticoagulation rates in elderly patients with atrial fibrillation may be suboptimal.
Purpose of the Study:
- To screen elderly individuals for atrial fibrillation.
- To determine the prevalence of atrial fibrillation in this demographic.
- To assess the proportion of patients with atrial fibrillation eligible for anticoagulant therapy.
Main Methods:
- Electrocardiographic screening of 1207 patients aged 65+.
- Echocardiography and clinical interviews for risk stratification.
- Physician interviews to understand anticoagulation prescribing factors.
Main Results:
- Atrial fibrillation detected in 5.4% of patients, increasing with age.
- Only 21.4% of eligible patients were on warfarin; an additional 20% were identified as eligible.
- High prevalence of cardiac comorbidities and structural heart changes observed.
Conclusions:
- Nearly half (41.4%) of elderly patients with atrial fibrillation are eligible for warfarin.
- Current anticoagulation use is only one-fifth of the eligible population.
- Clinical assessment is often sufficient for anticoagulation decisions, suggesting potential to double treatment rates.