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The feasibility of population screening for paroxysmal atrial fibrillation using hand-held electrocardiogram devices

Published version
Peer-reviewed

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Abstract

Aims: There are few data on the feasibility of population screening for paroxysmal atrial fibrillation (AF) using hand-held electrocardiogram (ECG) devices outside a specialist setting or in people over the age of 75. We investigated the feasibility of screening when conducted without face-to-face contact (‘remote’) or via in-person appointments in primary care and explored impact of age on screening outcomes. Methods and results: People aged ≥65 years from 13 general practices in England participated in screening during 2019–20. This involved attending a practice nurse appointment (10 practices) or receiving an ECG device by post (three practices). Participants were asked to use a hand-held ECG for 1–4 weeks. Screening outcomes included uptake, quality of ECGs, AF detection rates, and uptake of anticoagulation if AF was detected. Screening was carried out by 2141 (87.5%) of people invited to practice nurse-led screening and by 288 (90.0%) invited to remote screening. At least 56 interpretable ECGs were provided by 98.0% of participants who participated for 3 weeks, with no significant differences by setting or age, except people aged 85 or over (91.1%). Overall, 2.6% (64/2429) screened participants had AF, with detection rising with age (9.2% in people aged 85 or over). A total of 53/64 (82.8%) people with AF commenced anticoagulation. Uptake of anticoagulation did not vary by age. Conclusion: Population screening for paroxysmal AF is feasible in general practice and without face-to-face contact for all ages over 64 years, including people aged 85 and over.

Description

Funder: National Institute for Health and Care Research; DOI: https://doi.org/10.13039/501100000272


Funder: AFFECTEU


Funder: Wellcome Trust; DOI: https://doi.org/10.13039/100010269


Funder: ARC; DOI: https://doi.org/10.13039/100000163


Funder: OTV


Funder: Oxford BRC


Funder: NHS; DOI: https://doi.org/10.13039/100030827


Funder: New South Wales Health Senior Researcher Cardiovascular Grant

Keywords

Journal Title

Europace

Conference Name

Journal ISSN

1099-5129
1532-2092

Volume Title

26

Publisher

Oxford University Press
Sponsorship
Programme Grants for Applied Research (RP-PG-0217-20007)
NIHR School for Primary Care Research (SPCR-2014-10043)
European Union’s Horizon 2020 research and innovation programme (847770)
PhD Programme for Primary Care Clinicians (203921/Z/16/Z)
British Heart Foundation (FS/20/20/34626)