Atrial fibrillation (AF) is the most prevalent arrhythmia worldwide. The presence of AF is associated with increased risk of systemic thromboembolism but with the uptake of oral anticoagulation (OAC) and implementation of a holistic and integrated care management, this risk is substantially reduced. The diagnosis of AF requires a 30-seconds long electrocardiographic (ECG) trace, irrespective of the presence of symptoms, which may represent the main indication for an ECG tracing. However, almost half patients are asymptomatic at the time of incidental AF diagnosis, with similar risk of stroke of those with clinical AF. This has led to crucial role of screening for AF, to increase the diagnosis of population at risk of clinical events. The aim of this review is to give a comprehensive overview about the epidemiology of asymptomatic AF, the different screening technologies, the yield of diagnosis in asymptomatic population and the benefit derived from screening in terms of reduction of clinical adverse events, such as stroke, cardiovascular and all-cause death. We aim to underline the importance of implementing AF screening programmes and reporting about the debate between scientific societies’ clinical guidelines recommendations and the concerns expressed by the regulatory authorities, which still do not recommend population-wide screening. This review summarises data on the ongoing trials specifically designed to investigate the benefit of screening in terms of risk of adverse events which will further elucidate the importance of screening in reducing risk of outcomes and influence and inform clinical practice in the next future.

Yield of Diagnosis and Risk of Stroke with Screening Strategies for Atrial Fibrillation: A Comprehensive Review of Current Evidence / Corica, Bernadette; Bonini, Niccolò; Imberti, Jacopo Francesco; Romiti, Giulio Francesco; Vitolo, Marco; Attanasio, Lisa; Basili, Stefania; Freedman, Ben; Potpara, Tatjana S; Boriani, Giuseppe; Lip, Gregory Y H; Proietti, Marco. - In: EUROPEAN HEART JOURNAL OPEN. - ISSN 2752-4191. - (2023). [10.1093/ehjopen/oead031]

Yield of Diagnosis and Risk of Stroke with Screening Strategies for Atrial Fibrillation: A Comprehensive Review of Current Evidence

Corica, Bernadette
Primo
;
Romiti, Giulio Francesco;Basili, Stefania;
2023

Abstract

Atrial fibrillation (AF) is the most prevalent arrhythmia worldwide. The presence of AF is associated with increased risk of systemic thromboembolism but with the uptake of oral anticoagulation (OAC) and implementation of a holistic and integrated care management, this risk is substantially reduced. The diagnosis of AF requires a 30-seconds long electrocardiographic (ECG) trace, irrespective of the presence of symptoms, which may represent the main indication for an ECG tracing. However, almost half patients are asymptomatic at the time of incidental AF diagnosis, with similar risk of stroke of those with clinical AF. This has led to crucial role of screening for AF, to increase the diagnosis of population at risk of clinical events. The aim of this review is to give a comprehensive overview about the epidemiology of asymptomatic AF, the different screening technologies, the yield of diagnosis in asymptomatic population and the benefit derived from screening in terms of reduction of clinical adverse events, such as stroke, cardiovascular and all-cause death. We aim to underline the importance of implementing AF screening programmes and reporting about the debate between scientific societies’ clinical guidelines recommendations and the concerns expressed by the regulatory authorities, which still do not recommend population-wide screening. This review summarises data on the ongoing trials specifically designed to investigate the benefit of screening in terms of risk of adverse events which will further elucidate the importance of screening in reducing risk of outcomes and influence and inform clinical practice in the next future.
2023
atrial fibrillation; screening strategies; review; stroke
01 Pubblicazione su rivista::01a Articolo in rivista
Yield of Diagnosis and Risk of Stroke with Screening Strategies for Atrial Fibrillation: A Comprehensive Review of Current Evidence / Corica, Bernadette; Bonini, Niccolò; Imberti, Jacopo Francesco; Romiti, Giulio Francesco; Vitolo, Marco; Attanasio, Lisa; Basili, Stefania; Freedman, Ben; Potpara, Tatjana S; Boriani, Giuseppe; Lip, Gregory Y H; Proietti, Marco. - In: EUROPEAN HEART JOURNAL OPEN. - ISSN 2752-4191. - (2023). [10.1093/ehjopen/oead031]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/1675323
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