Yield of diagnosis and risk of stroke with screening strategies for atrial fibrillation: a comprehensive review of current evidence.



Corica, Bernadette ORCID: 0000-0001-9460-4435, Bonini, Niccolò, Imberti, Jacopo Francesco, Romiti, Giulio Francesco, Vitolo, Marco ORCID: 0000-0002-5196-6249, Attanasio, Lisa, Basili, Stefania ORCID: 0000-0002-6987-1926, Freedman, Ben ORCID: 0000-0002-3809-2911, Potpara, Tatjana S, Boriani, Giuseppe ORCID: 0000-0002-9820-4815
et al (show 2 more authors) (2023) Yield of diagnosis and risk of stroke with screening strategies for atrial fibrillation: a comprehensive review of current evidence. European heart journal open, 3 (2). oead031-.

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Abstract

Atrial fibrillation (AF) is the most prevalent arrhythmia worldwide. The presence of AF is associated with increased risk of systemic thromboembolism, but with the uptake of oral anticoagulant (OAC) and implementation of a holistic and integrated care management, this risk is substantially reduced. The diagnosis of AF requires a 30-s-long electrocardiographic (ECG) trace, irrespective of the presence of symptoms, which may represent the main indication for an ECG tracing. However, almost half patients are asymptomatic at the time of incidental AF diagnosis, with similar risk of stroke of those with clinical AF. This has led to a crucial role of screening for AF, to increase the diagnosis of population at risk of clinical events. The aim of this review is to give a comprehensive overview about the epidemiology of asymptomatic AF, the different screening technologies, the yield of diagnosis in asymptomatic population, and the benefit derived from screening in terms of reduction of clinical adverse events, such as stroke, cardiovascular, and all-cause death. We aim to underline the importance of implementing AF screening programmes and reporting about the debate between scientific societies' clinical guidelines recommendations and the concerns expressed by the regulatory authorities, which still do not recommend population-wide screening. This review summarizes data on the ongoing trials specifically designed to investigate the benefit of screening in terms of risk of adverse events which will further elucidate the importance of screening in reducing risk of outcomes and influence and inform clinical practice in the next future.

Item Type: Article
Uncontrolled Keywords: Atrial fibrillation, Review, Screening strategies, Stroke
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Life Courses and Medical Sciences
Depositing User: Symplectic Admin
Date Deposited: 19 May 2023 09:02
Last Modified: 19 May 2023 09:03
DOI: 10.1093/ehjopen/oead031
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3170535