The DOI matches its Crossref record; 56 of the 57 references it cites were found in a registry or an index.
Mass Screening for Untreated Atrial Fibrillation: The STROKESTOP Study
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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In the citing paper
“clinical trials to determine any benefit for opportunistically detected AF have not yet been completed but are underway (Gudmundsdottir 2020, Steinhubl 2018, Svennberg 2015; Heartline Study: www.heartline.com).”
From 2021 ISHNE/HRS/EHRA/APHRS Expert Collaborative Statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia-Pacific Heart Rhythm Society (2021) · cites this paper as Svennberg 2015
In the citing paper
“By focusing on older patients (75–76 years of age) at greater risk, Swedish studies identified new AF in 3% of study participants and up to 7.4% when additional risk factors beyond age were required (Engdahl 2013, Gudmundsdottir 2019, Svennberg 2015).29–31”
From 2021 ISHNE/HRS/EHRA/APHRS Expert Collaborative Statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia-Pacific Heart Rhythm Society (2021) · cites this paper as Svennberg 2015
In the citing paper
“These may be very useful to detect silent, undiagnosed AF.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [157]
In the citing paper
“Technological advances allow screening for an irregular pulse using patient-operated ECG devices, smartphones, and a variety of other technologies.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [157]
In the citing paper
“The overall prevalence of AF varies by ancestry; prevalence studies of Asian populations have been less consistent than those of North American and European poulations.”
From Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis (2016) · cites this paper as [20]
In the citing paper
“Two large cross-sectional studies of Chinese cohorts reported that age-adjusted prevalence of AF was similar in women and men (0.76% versus 0.78% and 0.63% versus 0.66%),20,21”
From Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis (2016) · cites this paper as [20]
Citations
Cites
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Guidelines for the management of atrial fibrillation
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2012 focused update of the ESC Guidelines for the management of atrial fibrillation
Authors Task Force Members, Camm, A. J., Lip, G. Y. H., Caterina, R. D., Savelieva, I., Atar, D., Hohnloser, S. H., Hindricks, G., Kirchhof, P. F., Bax, J. J., et al. (2012) · EP Europace · doi:10.1093/europace/eus305 · Cited by 3,823
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(1968) · Annals of Internal Medicine · doi:10.7326/0003-4819-69-5-1085_2 · Cited by 3,251
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Authors Task Force Members, Camm, A. J., Lip, G. Y. H., Caterina, R. D., Savelieva, I., Atar, D., Hohnloser, S. H., Hindricks, G., Kirchhof, P. F., Bax, J. J., et al. (2012) · European Heart Journal · doi:10.1093/eurheartj/ehs253 · Cited by 2,929
Guidelines for Management of Ischaemic Stroke and Transient Ischaemic Attack 2008
The European Stroke Organisation (ESO) Executive Committee and the ESO Writing Committee (2008) · Cerebrovascular Diseases · doi:10.1159/000131083 · Cited by 2,504
Cryptogenic stroke and underlying atrial fibrillation
Sanna, T., Diener, H.-C., Passman, R. S., Di Lazzaro, V., Bernstein, R. A., Morillo, C. A., Rymer, M. M., Thijs, V., Rogers, T., Beckers, F., et al. (2014) · New England Journal of Medicine · doi:10.1056/nejmoa1313600 · Cited by 2,161
Subclinical atrial fibrillation and the risk of stroke
Healey, J. S., Connolly, S. J., Gold, M. R., Israel, C. W., Van Gelder, I. C., Capucci, A., Lau, C. P., Fain, E., Yang, S., Bailleul, C., et al. (2012) · New England Journal of Medicine · doi:10.1056/nejmoa1105575 · Cited by 2,100
Kannel, W. B., Wolf, P. A., Benjamin, E. J., & Levy, D. (1998) · The American Journal of Cardiology · doi:10.1016/s0002-9149(98)00583-9 · Cited by 2,033
Cited by
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AbuBaha, M., Barqawi, Y. I., Abubaha, B., Bishawi, S., Hamada, D., Saleh, M., Saife, S., AlJallad, Y., Salah, E., Salah, A., et al. (2026) · Clinical Cardiology · doi:10.1002/clc.70468
Mansour, M. A., Hussein, M. E. I., & Foda, M. S. A.-D. T. (2026) · BMC Cardiovascular Disorders · doi:10.1186/s12872-026-06253-2
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Edder, A., Ben-Bouazza, F.-E., Bigane, Y. A., Sangare, D., Tafala, I., Manchadi, O., & Jioudi, B. (2026) · BioMedInformatics · doi:10.3390/biomedinformatics6050090
Metadata
- 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.).
- Venue
- Circulation
- Published
- 2015-06
- Volume
- 131
- Issue
- 25
- Pages
- 2176-2184
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- 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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