Cited by 605Atrial Fibrillation Management and OutcomesHealth Promotion and Cardiovascular PreventionAcute Ischemic Stroke Management

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Mass Screening for Untreated Atrial Fibrillation: The STROKESTOP Study

Svennberg, Emma, Engdahl, Johan, Al-Khalili, Faris, Friberg, Leif, Frykman, Viveka, Rosenqvist, Mårten·2015·Circulation

DOI 10.1161/circulationaha.114.014343

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Abstract

BACKGROUND: The aims of the present study were to define the prevalence of untreated atrial fibrillation (AF) in a systematic screening program using intermittent ECG recordings among 75- to 76-year-old individuals and to study the feasibility of initiating protective oral anticoagulant (OAC) treatment. METHODS AND RESULTS: Half of the 75- to 76-year-old population in 2 Swedish regions were invited to a screening program for AF. Participants without a previous diagnosis of AF underwent intermittent ECG recordings over 2 weeks. If AF was detected, participants were offered OAC. During the 28-month inclusion period, 13 331 inhabitants were invited. Of these, 7173 (53.8%) participated. Of the participants, 218 (3.0%; 95% confidence interval [CI], 2.7-3.5) were found to have previously unknown AF, and of these, AF was found in 37 (0.5% of the screened population) on their first ECG. The use of intermittent ECGs increased new AF detection 4-fold. A previous diagnosis of AF was known in 9.3% (n=666; 95% CI, 8.6-10.0). Total AF prevalence in the screened population was 12.3%. Of participants with known AF, 149 (2.1%; 95% CI, 1.8-2.4) had no OAC treatment. In total, 5.1% (95% CI, 4.6-5.7) of the screened population had untreated AF; screening resulted in initiation of OAC treatment in 3.7% (95% CI, 3.3-4.2) of the screened population. More than 90% of the participants with previously undiagnosed AF accepted initiation of OAC treatment. CONCLUSIONS: Mass screening for AF in a 75- to 76-year-old population identifies a significant proportion of participants with untreated AF. Initiation of stroke prophylactic treatment was highly successful in individuals with newly diagnosed AF. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01593553.

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Authors: Svennberg, E., Engdahl, J., Al-Khalili, F., Friberg, L., Frykman, V., & Rosenqvist, M.
Affiliations: Danderyds sjukhus (SE)
From Karolinska Institutet, Department of Clinical Sciences, Cardiology Unit, Danderyd’s University Hospital, Stockholm, Sweden (E.S., F.A.-K., L.F., V.F., M.R.); Department of Medicine, Halland’s Hospital, Halmstad, Sweden (J.E.); and Stockholm Heart Center, Sweden (F.A.-K.).
ORCID: Svennberg, Emma
Engdahl, Johan
Friberg, Leif
Frykman, Viveka
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2015-06
Volume: 131
Issue: 25
Pages: 2176-2184
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/circulationaha.114.014343
OpenAlex: W2020682484
Cited by: 605
References: 57
Citations by year: 2026: 35 · 2025: 29 · 2024: 42 · 2023: 47 · 2022: 55 · 2021: 97 · 2020: 68 · 2019: 63 · 2018: 61 · 2017: 50 · 2016: 51 · 2015: 7
FWCI: 40.91
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
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 › Clinical Neurology › Acute Ischemic Stroke Management
Keywords: atrial fibrillation, mass screening, oral anticoagulation, stroke prevention, prevalence, older adults, newly diagnosed atrial fibrillation, treatment initiation
MeSH terms: Aged, Atrial Fibrillation, Electrocardiography, Female, Humans, Male, Mass Screening, Prospective Studies, Risk Factors, Sweden, Stroke

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Mass Screening for Untreated Atrial Fibrillation: The STROKESTOP Study

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