RT Journal Article
SR Electronic
T1 Opportunistic atrial fibrillation screening in primary care in Ireland: results of a pilot screening programme
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e002563
DO 10.1136/openhrt-2023-002563
VO 11
IS 1
A1 Callanan, Aileen
A1 Quinlan, Diarmuid
A1 Kearney, Patricia M
A1 O’Sullivan, Susanne
A1 Zhi, Gerald Tan Ying
A1 Crichton, Alyssa
A1 Howell, Mackenzie Wynn
A1 Bradley, Colin
A1 Buckley, Claire
YR 2024
UL http://openheart.bmj.com/content/11/1/e002563.abstract
AB Background Atrial fibrillation (AF), a common, frequently asymptomatic cardiac arrhythmia, is a major risk factor for stroke. Identification of AF enables effective preventive treatment to be offered, potentially reducing stroke risk by up to two-thirds. There is international consensus that opportunistic AF screening is valuable though uncertainty remains about the optimum screening location and method. Primary care has been identified as a potential location for AF screening using one-lead ECG devices.Methods A pilot AF screening programme is in primary care in the south of Ireland. General practitioners (GPs) were recruited from Cork and Kerry. GPs invited patients ≥65 years to undergo AF screening. The screening comprised a one-lead ECG device, Kardia Mobile, blood pressure check and ascertainment of smoking status. Possible AF on one-lead ECG was confirmed with a 12-lead ECG. GPs also recorded information including medical history, current medication and onward referral. The Keele Decision Support tool was used to assess patients for oral anticoagulation (OAC).Results 3555 eligible patients, attending 52 GPs across 34 GP practices, agreed to undergo screening. 1720 (48%) were female, 1780 (50%) were hypertensive and 285 (8%) were current smokers. On the one-lead ECG, 3282 (92%) were in normal sinus rhythm, 101 (3%) had possible AF and among 124 (4%) the one-lead ECG was unreadable or unclassified. Of the 101 patients with possible AF, 45 (45%) had AF confirmed with 12-lead ECG, an incidence rate of AF of 1.3%. Among the 45 confirmed AF cases, 27 (60%) were commenced on OAC therapy by their GP.Conclusion These findings suggest that AF screening in primary care may prove useful for early detection of AF cases that can be assessed for treatment. One-lead ECG devices may be useful in the detection of paroxysmal AF in this population and setting. Current OAC of AF may be suboptimal.Data are available on reasonable request. The data underlying this article cannot be shared publicly due to protect the privacy of individuals that participated in the study. The anonymised data may be shared on reasonable request to the corresponding author.