Screening for undiagnosed atrial fibrillation in the community
Abstract
PURPOSE OF REVIEW: Recent years have seen significant advances in knowledge about the prevalence of 'silent' atrial fibrillation and the morbidity associated with this condition. Data are emerging on improved strategies for screening, and new technologies for detecting atrial fibrillation are becoming available, making a review of this field timely. RECENT FINDINGS: Studies suggest that, when screening is performed, undiagnosed atrial fibrillation is present in around 1% of the screened population, rising to 1.4% for those aged at least 65 years. The prevalence of silent atrial fibrillation is even higher in patients with additional risk factors (e.g. those aged 75 years, patients with heart failure). Prolonged monitoring of patients with hypertension and an implanted cardiac device showed subclinical atrial arrhythmias in at least 10% and these patients had a 2.5-fold increased risk of stroke or systemic embolism. The feasibility of screening for silent atrial fibrillation has been demonstrated in a number of populations and many new technologies for atrial fibrillation detection exist, which could improve the efficiency and cost-effectiveness of this process. SUMMARY: Increased attention is being directed towards screening for silent atrial fibrillation and our 'toolbox' for detecting it is expanding. Whether this will translate into improved outcomes for patients remains to be proven.
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The detection rate of asymptomatic AF by new technologies such as smartphone cases with ECG electrodes, smart watches, and blood pressure machines with AF detection algorithms has not yet been formally evaluated against an established arrhythmia detection method.
“The detection rate of asymptomatic AF by new technologies such as smartphone cases with ECG electrodes, smart watches, and blood pressure machines with AF detection algorithms, has not yet been formally evaluated against an established arrhythmia detection method.140”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [140]
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- Authors
- Quinn, F. R., & Gladstone, D.
- Affiliations
- Sunnybrook Health Science Centre (CA)
- Corresponding author
- Quinn, F. Russell
- ORCID
- Gladstone, David
- Venue
- Current Opinion in Cardiology
- Published
- 2014-01
- Volume
- 29
- Issue
- 1
- Pages
- 28-35
- ISSN
- 0268-4705 (ISSN-L)
- OpenAlex
- W2012180585
- Cited by
- 34
- References
- 31
- Citations by year
- 2025: 1 · 2024: 3 · 2023: 2 · 2022: 3 · 2021: 2 · 2020: 1 · 2019: 2 · 2018: 3 · 2017: 6 · 2016: 4 · 2015: 5 · 2014: 2
- FWCI
- 0.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Bristol-Myers Squibb
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cardiovascular and Diving-Related Complications
- Keywords
- silent atrial fibrillation, undiagnosed atrial fibrillation, atrial fibrillation screening, community-based screening, prevalence, stroke risk, systemic embolism, cardiac implantable electronic devices, hypertension, heart failure, cost-effectiveness
- MeSH terms
- Atrial Fibrillation, Electrocardiography, Humans, Mass Screening, Risk Factors, Electrocardiography, Ambulatory, Asymptomatic Diseases
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