Atrial fibrillation screening

Jump to navigation Jump to search


Resident
Survival
Guide


Sinus rhythm
Atrial fibrillation

Atrial Fibrillation Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Atrial Fibrillation from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Special Groups

Postoperative AF
Acute Myocardial Infarction
Wolff-Parkinson-White Preexcitation Syndrome
Hypertrophic Cardiomyopathy
Hyperthyroidism
Pulmonary Diseases
Pregnancy
ACS and/or PCI or valve intervention
Heart failure

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

EKG Examples
A-Fib with LBBB

Chest X Ray

Echocardiography

Holter Monitoring and Exercise Stress Testing

Cardiac MRI

Treatment

Rate and Rhythm Control

Cardioversion

Overview
Electrical Cardioversion
Pharmacological Cardioversion

Anticoagulation

Overview
Warfarin
Converting from or to Warfarin
Converting from or to Parenteral Anticoagulants
Dabigatran

Maintenance of Sinus Rhythm

Surgery

Catheter Ablation
AV Nodal Ablation
Surgical Ablation
Cardiac Surgery

Specific Patient Groups

Primary Prevention

Secondary Prevention

Supportive Trial Data

Cost-Effectiveness of Therapy

Case Studies

Case #1

Atrial fibrillation screening On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Atrial fibrillation screening

CDC on Atrial fibrillation screening

Atrial fibrillation screening in the news

Blogs on Atrial fibrillation screening

Directions to Hospitals Treating Atrial fibrillation screening

Risk calculators and risk factors for Atrial fibrillation screening

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

Practice guidelines by the European Society of Cardiology (ESC recommend[1]:

  • "Opportunistic screening for AF by pulse taking or ECG rhythm strip is recommended in patients >_65 years of age"
  • "It is recommended to interrogate pacemakers and implantable cardioverter defibrillators on a regular basis for AHRE"
  • "Systematic ECG screening should be considered to detect AF in individuals aged >_75 years, or those at high risk of stroke.2"


A systematic review of trials through November, 2019 by the Cochrance Collaboration concluded[2]:

  • " Evidence suggests that systematic screening and opportunistic screening for AF increase the rate of detection of new cases compared with routine practice"


Randomized controlled trials have looked at various screening methods:

  • Implantable loop recorders increased detection, but did not reduce morbidity[3]

Cost effectiveness

References

  1. Hindricks G, Potpara T, Dagres N, Arbelo E, Bax JJ, Blomström-Lundqvist C; et al. (2021). "2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS): The Task Force for the diagnosis and management of atrial fibrillation of the European Society of Cardiology (ESC) Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC". Eur Heart J. 42 (5): 373–498. doi:10.1093/eurheartj/ehaa612. PMID 32860505 Check |pmid= value (help).
  2. Moran PS, Teljeur C, Ryan M, Smith SM (2016). "Systematic screening for the detection of atrial fibrillation". Cochrane Database Syst Rev (6): CD009586. doi:10.1002/14651858.CD009586.pub3. PMC 7105908 Check |pmc= value (help). PMID 27258214.
  3. Svendsen JH, Diederichsen SZ, Højberg S, Krieger DW, Graff C, Kronborg C; et al. (2021). "Implantable loop recorder detection of atrial fibrillation to prevent stroke (The LOOP Study): a randomised controlled trial". Lancet. doi:10.1016/S0140-6736(21)01698-6. PMID 34469766 Check |pmid= value (help).
  4. Svennberg E, Friberg L, Frykman V, Al-Khalili F, Engdahl J, Rosenqvist M (2021). "Clinical outcomes in systematic screening for atrial fibrillation (STROKESTOP): a multicentre, parallel group, unmasked, randomised controlled trial". Lancet. doi:10.1016/S0140-6736(21)01637-8. PMID 34469764 Check |pmid= value (help).
  5. Wheeldon NM, Tayler DI, Anagnostou E, Cook D, Wales C, Oakley GD (1998). "Screening for atrial fibrillation in primary care". Heart. 79 (1): 50–5. doi:10.1136/hrt.79.1.50. PMC 1728588. PMID 9505919.
  6. Jabaudon D, Sztajzel J, Sievert K, Landis T, Sztajzel R (2004). "Usefulness of ambulatory 7-day ECG monitoring for the detection of atrial fibrillation and flutter after acute stroke and transient ischemic attack". Stroke. 35 (7): 1647–51. doi:10.1161/01.STR.0000131269.69502.d9. PMID 15155965.
  7. 7.0 7.1 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
  8. 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.
  9. 9.0 9.1 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.

Template:WH Template:WS CME Category::Cardiology