screening for atrial fibrillation
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Clinical significance
- screening elderly >=75 years with hypertension, thus minimal CHADS2-VASC score of 3, yields 5% with atrial fibrillation vs 0.5% if discovered without screening[4]
- clinical benefit is unclear[4]
- USPSTF concludes evidence is insufficient to recommend for or against screening[4][5]
- screening for atrial fibrillation in primary care with a single hand-held ECG of no benefit[6]
Procedure
- palpating pulse for irregularly irregular rhythm
- most cost effective approach to detect atrial fibrillation
- follow-up electrocardiogram if not regular rate & rhythm[1][2]
- screening with electrocardiogram not indicated (USPSTF)[3]
More general terms
Additional terms
References
- ↑ 1.0 1.1 Medical Knowledge Self Assessment Program (MKSAP) 17, 18. American College of Physicians, Philadelphia 2015, 2018.
- ↑ 2.0 2.1 Fitzmaurice DA, Hobbs FD, Jowett S et al Screening versus routine practice in detection of atrial fibrillation in patients aged 65 or over: cluster randomised controlled trial. BMJ. 2007 Aug 25;335(7616):383. Epub 2007 Aug 2. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17673732 Free PMC Article
- ↑ 3.0 3.1 Draft Recommendation Statement. Dec 2017 Atrial Fibrillation: Screening With Electrocardiography https://www.uspreventiveservicestaskforce.org/Page/Document/draft-recommendation-statement/atrial-fibrillation-screening-with-electrocardiography
Draft Evidence Review. Dec 2017 Draft Evidence Review for Atrial Fibrillation: Screening With Electrocardiography. https://www.uspreventiveservicestaskforce.org/Page/Document/draft-evidence-review/atrial-fibrillation-screening-with-electrocardiography
Curry SJ et al. Screening for atrial fibrillation with electrocardiography: US Preventive Services Task Force recommendation statement. JAMA 2018 Aug 7; 320:478. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30088016 https://jamanetwork.com/journals/jama/fullarticle/2695678
Jonas DE et al. Screening for atrial fibrillation with electrocardiography: Evidence report and systematic review for the US Preventive Services Task Force. JAMA 2018 Aug 7; 320:485. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30088015 https://jamanetwork.com/journals/jama/fullarticle/2695677
Goldberger JJ, Mitrani RD. Electrocardiographic monitoring for prevention of atrial fibrillation-associated cardioembolic stroke. JAMA 2018 Aug 7; 320:447. PMID: https://www.ncbi.nlm.nih.gov/pubmed/30087990 https://jamanetwork.com/journals/jama/fullarticle/2695650
US Preventive Services Task Force (USPSTF) Screening for Atrial Fibrillation Draft Recommendation Statement, April 20, 2021 https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/screening-atrial-fibrillation
Draft Recommendation Review, April 20, 2021 https://www.uspreventiveservicestaskforce.org/uspstf/document/draft-evidence-review/screening-atrial-fibrillation - ↑ 4.0 4.1 4.2 4.3 Gladstone DJ, Wachter R, Schmalstieg-Bahr K et al. Screening for atrial fibrillation in the older population: A randomized clinical trial. JAMA Cardiol 2021 Feb 24; [e-pub] PMID: https://www.ncbi.nlm.nih.gov/pubmed/33625468 PMCID: PMC7905702 (available on 2022-02-24) https://jamanetwork.com/journals/jamacardiology/article-abstract/2776728
- ↑ 5.0 5.1 US Preventive Services Task Force Screening for Atrial Fibrillation. US Preventive Services Task Force Recommendation Statement. JAMA. 2022;327(4):360-367 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35076659 https://jamanetwork.com/journals/jama/fullarticle/2788340
Kahwati LC, Asher GN, Kadro ZO et al Screening for Atrial Fibrillation. Updated Evidence Report and Systematic Review for the US Preventive Services Task Force. JAMA. 2022;327(4):368-383 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35076660 https://jamanetwork.com/journals/jama/fullarticle/2788341
Greenland P Screening for Atrial Fibrillation - More Data Still Needed JAMA. 2022;327(4):329-330 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35076684 https://jamanetwork.com/journals/jama/fullarticle/2788368
Kalscheur MM, Goldberger ZD Screening for Atrial Fibrillation - Refining the Target. JAMA Netw Open. 2022;5(1):e2139910 PMID: https://www.ncbi.nlm.nih.gov/pubmed/35076707 Free article https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2788386
Passman R, Freedman B. Updated USPSTF Guidelines for Screening for Atrial Fibrillation. Same as It Ever Was? JAMA Cardiol. Published online January 25, 2022. PMID: https://www.ncbi.nlm.nih.gov/pubmed/35076686 https://jamanetwork.com/journals/jamacardiology/fullarticle/2788234
Phen C USPSTF Not Backing Afib Screening, Even With Wearables. Experts agree but see no stopping it. MedPage Today January 25, 2022 https://www.medpagetoday.com/cardiology/arrhythmias/96842 - ↑ 6.0 6.1 Lubitz SA, Atlas SJ, Ashburner JM et al. Screening for atrial fibrillation in older adults at primary care visits: The VITAL-AF randomized controlled trial. Circulation 2022 Mar 2 PMID: https://www.ncbi.nlm.nih.gov/pubmed/3523221 https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.121.057014