Atrial fibrillation screening
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Atrial fibrillation screening On the Web | |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]
Overview
Early diagnosis of atrial fibrillation and proper prophylactic treatment can prevent numerous related complications, such as stroke and mortality. Since patients older than 65 are more prone to atrial fibrillation and the aforementioned complications, it has been recommended to perform screening at least in this age group. Electrocardiogram (12-lead ECG) has been introduced as the gold standard method for atrial fibrillation screening. Nevertheless atrial fibrillation screening can be done by simply checking pulse. The other reason to support atrial fibrillation screening is the cost effectiveness of it.
Screening
- Screening for atrial fibrillation is generally not performed, although a systematic review of studies by the Cochrane Collaboration found increased rate of atrial fibrillation detection from screening.[1]
- A study of routine pulse check or electrocardiogram during routine office visits found that the annual rate of atrial fibrillation diagnosis in elderly patients improved from 1.04% to 1.63%. Since identification of such patients for prophylactic anticoagulation might in turn reduce the risk of stroke in that age category.[2]
- The estimated sensitivity of the routine primary care visit in the detection of atrial fibrillation is 64%. This low sensitivity probably reflects the fact that the pulse is not being checked routinely or carefully.[2]
- Since screening for atrial fibrillation has shown a significant reduce in atrial fibrillation related complications in patients older than 65 years old, it is recommended to perform opportunistic screening in this age group by pulse taking or performing an electrocardiogram (ECG).[3][4]
- Electrocardiogram (12-lead ECG) has been introduced as the gold standard method for atrial fibrillation screening.[3]
- The other reason to support atrial fibrillation screening is the cost effectiveness of it. Based on several studies, since screening prevent numerous atrial fibrillation's complications (such as stroke and mortality). [5][6]
- Other methods such as 7 days Holter monitoring also could be considered for atrial fibrillation screening.[6]
References
- ↑ Moran PS, Flattery MJ, Teljeur C, Ryan M, Smith SM (2013). "Effectiveness of systematic screening for the detection of atrial fibrillation". Cochrane Database Syst Rev. 4: CD009586. doi:10.1002/14651858.CD009586.pub2. PMID 23633374.
- ↑ 2.0 2.1 Fitzmaurice DA, Hobbs FD, Jowett S, Mant J, Murray ET, Holder R; et al. (2007). "Screening versus routine practice in detection of atrial fibrillation in patients aged 65 or over: cluster randomised controlled trial". BMJ. 335 (7616): 383. doi:10.1136/bmj.39280.660567.55. PMC 1952508. PMID 17673732. Review in: Evid Based Med. 2008 Apr;13(2):45
- ↑ 3.0 3.1 Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B; et al. (2016). "2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS". Eur Heart J. 37 (38): 2893–2962. doi:10.1093/eurheartj/ehw210. PMID 27567408.
- ↑ Giebel GD, Gissel C (2019). "Accuracy of mHealth Devices for Atrial Fibrillation Screening: Systematic Review". JMIR Mhealth Uhealth. 7 (6): e13641. doi:10.2196/13641. PMC 6598422 Check
|pmc=value (help). PMID 31199337. - ↑ Jacobs MS, Kaasenbrood F, Postma MJ, van Hulst M, Tieleman RG (2018). "Cost-effectiveness of screening for atrial fibrillation in primary care with a handheld, single-lead electrocardiogram device in the Netherlands". Europace. 20 (1): 12–18. doi:10.1093/europace/euw285. PMID 27733465.
- ↑ 6.0 6.1 Mayer F, Stahrenberg R, Gröschel K, Mostardt S, Biermann J, Edelmann F; et al. (2013). "Cost-effectiveness of 7-day-Holter monitoring alone or in combination with transthoracic echocardiography in patients with cerebral ischemia". Clin Res Cardiol. 102 (12): 875–84. doi:10.1007/s00392-013-0601-2. PMC 3826055. PMID 23904073.