Atrial fibrillation screening: Difference between revisions
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==Overview== | ==Overview== | ||
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==Screening== | ==Screening== | ||
[[Screening (medicine)|Screening]] for atrial fibrillation is generally not performed, although a [[systematic review]] of studies by the [[Cochrane Collaboration]] found increased detection from screening.<ref name="pmid23633374">{{cite journal| author=Moran PS, Flattery MJ, Teljeur C, Ryan M, Smith SM| title=Effectiveness of systematic screening for the detection of atrial fibrillation. | journal=Cochrane Database Syst Rev | year= 2013 | volume= 4 | issue= | pages= CD009586 | pmid=23633374 | doi=10.1002/14651858.CD009586.pub2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23633374 }} </ref> | *[[Screening (medicine)|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 (medicine)|screening]].<ref name="pmid23633374">{{cite journal| author=Moran PS, Flattery MJ, Teljeur C, Ryan M, Smith SM| title=Effectiveness of systematic screening for the detection of atrial fibrillation. | journal=Cochrane Database Syst Rev | year= 2013 | volume= 4 | issue= | pages= CD009586 | pmid=23633374 | doi=10.1002/14651858.CD009586.pub2 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23633374 }} </ref> | ||
*A study of routine [[pulse]] check or [[electrocardiogram]] during routine office visits found that the annual rate of [[atrial fibrillation]] [[diagnosis]] in [[old age|elderly]] [[patients]] improved from 1.04% to 1.63%. Since identification of such [[patients]] for [[Prophylaxis|prophylactic]] [[anticoagulation]] might in turn reduce the risk of [[stroke]] in that age category.<ref name="pmid17673732">{{cite journal| author=Fitzmaurice DA, Hobbs FD, Jowett S, Mant J, Murray ET, Holder R et al.| title=Screening versus routine practice in detection of atrial fibrillation in patients aged 65 or over: cluster randomised controlled trial. | journal=BMJ | year= 2007 | volume= 335 | issue= 7616 | pages= 383 | pmid=17673732 | doi=10.1136/bmj.39280.660567.55 | pmc=PMC1952508 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17673732 }} [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18375698 Review in: Evid Based Med. 2008 Apr;13(2):45] </ref> | |||
The estimated [[sensitivity (tests)|sensitivity]] of the routine primary care visit in the detection of atrial fibrillation is 64%. | *The estimated [[sensitivity (tests)|sensitivity]] of the routine primary care visit in the detection of [[atrial fibrillation]] is 64%. This low [[sensitivity (tests)|sensitivity]] probably reflects the fact that the [[pulse]] is not being checked routinely or carefully.<ref name="pmid17673732">{{cite journal| author=Fitzmaurice DA, Hobbs FD, Jowett S, Mant J, Murray ET, Holder R et al.| title=Screening versus routine practice in detection of atrial fibrillation in patients aged 65 or over: cluster randomised controlled trial. | journal=BMJ | year= 2007 | volume= 335 | issue= 7616 | pages= 383 | pmid=17673732 | doi=10.1136/bmj.39280.660567.55 | pmc=PMC1952508 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17673732 }} [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18375698 Review in: Evid Based Med. 2008 Apr;13(2):45] </ref> | ||
*Since [[Screening (medicine)|screening]] for [[atrial fibrillation]] has shown a significant reduce in [[atrial fibrillation]] related [[Complication (medicine)|complications]] in [[patients]] older than 65 years old, it is recommended to perform opportunistic [[Screening (medicine)|screening]] in this age group by [[pulse]] taking or performing an [[electrocardiogram]] ([[electrocardiogram|ECG]]).<ref name="pmid27567408">{{cite journal| author=Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B | display-authors=etal| title=2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. | journal=Eur Heart J | year= 2016 | volume= 37 | issue= 38 | pages= 2893-2962 | pmid=27567408 | doi=10.1093/eurheartj/ehw210 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27567408 }} </ref><ref name="pmid31199337">{{cite journal| author=Giebel GD, Gissel C| title=Accuracy of mHealth Devices for Atrial Fibrillation Screening: Systematic Review. | journal=JMIR Mhealth Uhealth | year= 2019 | volume= 7 | issue= 6 | pages= e13641 | pmid=31199337 | doi=10.2196/13641 | pmc=6598422 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31199337 }} </ref> | |||
A | *[[Electrocardiogram]] (12-lead [[electrocardiogram|ECG]]) has been introduced as the gold standard method for [[atrial fibrillation]] [[Screening (medicine)|screening]].<ref name="pmid27567408">{{cite journal| author=Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B | display-authors=etal| title=2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. | journal=Eur Heart J | year= 2016 | volume= 37 | issue= 38 | pages= 2893-2962 | pmid=27567408 | doi=10.1093/eurheartj/ehw210 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27567408 }} </ref> | ||
*The other reason to support [[atrial fibrillation]] [[Screening (medicine)|screening]] is the cost effectiveness of it. Based on several studies, since [[Screening (medicine)|screening]] prevent numerous [[atrial fibrillation]]'s [[Complication (medicine)|complications]] (such as [[stroke]] and [[mortality rate|mortality]]). <ref name="pmid27733465">{{cite journal| author=Jacobs MS, Kaasenbrood F, Postma MJ, van Hulst M, Tieleman RG| title=Cost-effectiveness of screening for atrial fibrillation in primary care with a handheld, single-lead electrocardiogram device in the Netherlands. | journal=Europace | year= 2018 | volume= 20 | issue= 1 | pages= 12-18 | pmid=27733465 | doi=10.1093/europace/euw285 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27733465 }} </ref><ref name="pmid23904073">{{cite journal| author=Mayer F, Stahrenberg R, Gröschel K, Mostardt S, Biermann J, Edelmann F | display-authors=etal| title=Cost-effectiveness of 7-day-Holter monitoring alone or in combination with transthoracic echocardiography in patients with cerebral ischemia. | journal=Clin Res Cardiol | year= 2013 | volume= 102 | issue= 12 | pages= 875-84 | pmid=23904073 | doi=10.1007/s00392-013-0601-2 | pmc=3826055 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23904073 }} </ref> | |||
*Other methods such as 7 days [[Holter monitor|Holter monitoring]] also could be considered for [[atrial fibrillation]] [[Screening (medicine)|screening]].<ref name="pmid23904073">{{cite journal| author=Mayer F, Stahrenberg R, Gröschel K, Mostardt S, Biermann J, Edelmann F | display-authors=etal| title=Cost-effectiveness of 7-day-Holter monitoring alone or in combination with transthoracic echocardiography in patients with cerebral ischemia. | journal=Clin Res Cardiol | year= 2013 | volume= 102 | issue= 12 | pages= 875-84 | pmid=23904073 | doi=10.1007/s00392-013-0601-2 | pmc=3826055 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23904073 }} </ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 19:39, 31 August 2021
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Resident Survival Guide |
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Sinus rhythm  |
Atrial fibrillation  |
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Atrial Fibrillation Microchapters | |
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Special Groups | |
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Diagnosis | |
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Treatment | |
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Cardioversion | |
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Anticoagulation | |
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Surgery | |
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Case Studies | |
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Atrial fibrillation screening On the Web | |
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Directions to Hospitals Treating Atrial fibrillation screening | |
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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
Screening for atrial fibrillation is generally not performed, although a study of routine pulse checks or electrocardiograms during routine office visits found that the annual rate of detection of atrial fibrillation in elderly patients improved from 1.04% to 1.63%.[1]
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.[2]
- 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.[1]
- 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.[1]
- 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
- ↑ 1.0 1.1 1.2 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
- ↑ 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.
- ↑ 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.