Background Atrial Fibrillation (AF) a common, frequently asymptomatic condition is a major risk factor for stroke. Identification of AF enables effective preventive treatment to be offered with potential to reduce stroke risk by up to two thirds. While there is international consensus that AF screening is valuable what is less clear is the optimal mode and location for AF screening. Primary care has been identified as a potential location for AF screening. One lead ECG devices have been found to be more accurate than pulse palpation in detecting AF.
Methods A pilot AF screening programme in primary care in southern Ireland using a one-lead ECG device, KardiaMobile. General practitioners (GPs) were recruited from Cork and Kerry. GPs opportunistically invited patients ≥65 years attending for GP visits to undergo AF screening, blood pressure check and identification of smoking status. Data was returned to researchers at UCC using a clinical report form.
Results Anonymised data from 2298 patients, 52 GPs and 33 GP practices was collected. Among the 2298, 46% (1051) female, 50% (1162) male, 4% (85) gender was not recorded, patients screened, 109 (4.7%) patients with previously undiagnosed AF were detected 3.4% (79) were male, 1% (25) female, 0.3% (7) gender was not recorded. These patients ranged in age from 65–100y, average age 71y.
Discussion One-lead ECG screening for AF appears to be feasible in Irish general practice and may prove useful for early detection of AF. The yield of newly detected AF in this study is similar to other studies where the AF detection rate ranged from 0.1% to 5%. There was a higher proportion of AF detected in participants aged 80 years and over, this is consistent with other studies where AF is more commonly detected in the older age groups. These finding s can be used to inform a national screening programme in Ireland.
These findings suggest that AF screening in primary care is feasible and can lead to detection of newly diagnosed cases of AF who can be assessed for treatment. The findings are consistent with other previous studies where the newly detected rate of AF was estimated to be between 0.1%-5%. This study identified a higher proportion of newly diagnosed AF in males which is similar to previous studies where males were twice as likely to be diagnosed with AF than females.
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