Increased yield for repeated handheld ECG screening at 6-12 month intervals to detect atrial fibrillation during outpatient clinic reviews
Refereed conference paper presented and published in conference proceedings

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摘要Background: Current guidelines recommend opportunistic screening for atrial fibrillation (AF) in patients aged ≥65 years. However, it is uncertain whether single-time point screening should be repeated at intervals to increase diagnostic yield.
Purpose: We evaluated the sequential yield of repeating routine AF screening using a handheld single-lead ECG during follow-up outpatient clinic visits in those negative on previous single-time point screening.
Methods: 12,928 consecutive patients aged ≥65 years attending medical outpatient clinics underwent AF screening using a handheld single-lead ECG with automated AF diagnostics (AliveCor) from Dec 2014 to Dec 2016 (NCT02409654). Repeated screening was performed on the same patients who had >1 clinic visit during the study period. Diagnostic yield is defined by detection of new AF. Patients with screen-detected AF were excluded from subsequent screening.
Results: 12,928 patients (mean age 71.7±12.0 years; 50.2% male) underwent 16,417 screening events during the study period. Of patients without AF detected by previous screening, 21.8% (n=2813), 4.3% (n=554) and 0.9% (n=114) underwent repeated screening 2, 3 and 4 times, respectively. The mean duration between 1st - 2nd, and 2nd - 3rd visits was 9.0±5.4 and 7.3±4.5 months, respectively. The yield of detection of previously undiagnosed AF was lower from 1st screen (1.2%; n=156/12928) to 2nd (0.8%; n=22/2813), 3rd (0.4%; n=2/554) and 4th (0.9%; n=1/114) screening events, though not significant (p=0.1). Mean CHA2DS2-VASc score of patients with newly diagnosed AF was 3.9±1.6 and mean age was 78.0±9.5 years.
Conclusion: Routine AF screening with a handheld ECG in an outpatient setting is feasible with approximately 1% yield in detecting new AF each time. Patients detected have a high enough calculated stroke risk to warrant anticoagulant therapy. Our study suggests that repeat AF screening at 6–12 month follow-up visits may be reasonable to increase detection of previously unknown AF over a single screen.
著者BPY Yan, LLY. Chan, W Sun, G Tse, OTL To, VWY Lee, B Freedman
會議名稱European Society of Cardiology Congress 2017
會議開始日26.08.2017
會議完結日30.08.2017
會議地點Barcelona
會議國家/地區西班牙
會議論文集題名European Heart Journal
出版年份2017
月份8
日期29
卷號38
期次Supplement 1
語言英式英語

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