Screening for undiagnosed atrial fibrillation

ABSTRACT

Introduction: Atrial fibrillation (AF) is a condition of global importance, and it is associated with significant morbidity, mortality, and healthcare costs. A considerable proportion of patients with AF are asymptomatic, and stroke may be the first clinical manifestation of their AF diagnosis. AF screening provides an opportunity to identify patients with undetected AF prior to suffering a devastating complication.

Areas covered: This review will provide a rationale for AF screening; summarize AF screening methods, studies, and economic analyses; evaluate AF as a condition meeting criteria for population screening; and discuss potential drawbacks.

Expert commentary: While AF screening is simple, low risk, and, in most cases, low cost, additional research is needed validating new technologies and devices; defining strategies for linking screening with initiation of oral anticoagulation therapy and determining whether AF screening ultimately reduces stroke and stroke-related complications and costs.

KEYWORDS:

• Atrial fibrillation
• screening
• stroke
• oral anticoagulation therapy
• cost-effectiveness

Declaration of interest

K Sandhu receives honorarium from Bayer (Canadian Cardiovascular Society Vascular Resident Award grant panel) and J Healey receives research grants from Bayer, BMS/Pfizer, and Medtronic. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.