Atrial fibrillation screening

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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 detection from screening.[2] For example, 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] Identification of such patients for prophylactic anticoagulation might in turn reduce the risk of stroke in that age category.

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]

A young patient with lone atrial fibrillation should be assessed for short QT syndrome.

References

  1. 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
  2. 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.

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