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Clinical Articles, Lead Article

Stepwise AF screening in the elderly

Stepwise risk factor-stratified atrial fibrillation (AF) screening in a 75-year old plus population yields a large share of candidates for oral anticoagulant (OAC) treatment, according to a study1 published recently in Circulation.

848 inhabitants of Halmstad, Sweden, aged 75–76, participated in a stepwise screening program for AF. As a first step, participants recorded a 12-lead ECG and reported their relevant medical history. Those with sinus rhythm on 12-lead ECG, no history of AF and at least two risk factors according to CHADS2 were invited to a two week recording period using a hand-held ECG asked to record 20 or 30 seconds twice daily and if palpitations occurred.

Previously undiagnosed silent AF was found in (1%) of individuals who recorded 12-lead ECG. Among 81 patients with known AF, 35 (43%) were not on OAC treatment. Among 403 persons with at least two risk factors for stroke, who completed the hand-held ECG event recording, 30 (7.4%) were diagnosed with paroxysmal AF. Thus 75/848 (9%) of the screened population were candidates for new OAC treatment, of those 57 actually started OAC treatment.


1. Engdahl J, Andersson L, Mirskaya M, Rosenqvist M. Stepwise screening of atrial fibrillation in a 75-Year old population: implications for stroke prevention. Circulation 2013.​CIRCULATIONAHA.112.126656

Published on: February 28, 2013

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  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association

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