Effect of Screening for Undiagnosed Atrial Fibrillation on Stroke Prevention
Authors: Renato D. Lopes, Steven J. Atlas, Alan S. Go, Steven A. Lubitz, David D. McManus, Rowena J. Dolor, Ranee Chatterjee, Michael B. Rothberg, David R. Rushlow, Lori A. Crosson, Ronald S. Aronson, Michael Patlakh, Dianne Gallup, Donna J. Mills, Emily C. O’Brien, and Daniel E. Singer.
Summary:
Prospective randomized control trial designed to test whether screening for AF in people over 70 years old using a 14 day ECG (Zio XT) could identify patients with undiagnosed AF and reduce stroke in the primary care setting.
Key Findings:
- Screening this population did not reduce stroke hospitalizations – mitigating factors included COVID19 pandemic, slow enrollment and early termination of trial
- Risk of stroke in the screening group was 0.7% vs 0.6% in the usual care group
- Risk of bleeding was 1.0% in the screening group vs 1.1% in the usual care group
- Diagnosis of AF was 5% in the screening group and 3.3% in the usual care group
- Initiation of oral anticoagulation after randomization was 4.2% om screening group and 2.8% in usual care group
