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Circulation. 2015 Jun 23;131(25):2176-84. doi: 10.1161/CIRCULATIONAHA.114.014343. Epub 2015 Apr 24.

Mass Screening for Untreated Atrial Fibrillation: The STROKESTOP Study.

Author information

1
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.). emma.svennberg@ds.se.
2
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.).

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.

KEYWORDS:

anticoagulants; atrial fibrillation; mass screening; prevention and control; stroke

[Indexed for MEDLINE]

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