To Screen or Not to Screen? Examining the Arguments Against Screening for Atrial Fibrillation

Lis Neubeck; Jessica Orchard; Nicole Lowres; S Ben Freedman

doi:10.1016/j.hlc.2017.05.118

To Screen or Not to Screen? Examining the Arguments Against Screening for Atrial Fibrillation

Heart Lung Circ. 2017 Sep;26(9):880-886. doi: 10.1016/j.hlc.2017.05.118. Epub 2017 May 24.

Authors

Lis Neubeck¹, Jessica Orchard², Nicole Lowres³, S Ben Freedman⁴

Affiliations

¹ School of Health and Social Care, Edinburgh Napier University, Edinburgh, Scotland, UK; School of Nursing and Midwifery, Faculty of Medicine, Nursing, and Health Sciences, Flinders University, Adelaide, SA, Australia; Sydney Nursing School, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia. Electronic address: l.neubeck@napier.ac.uk.
² Sydney Nursing School, University of Sydney, Sydney, NSW, Australia.
³ Sydney Nursing School, University of Sydney, Sydney, NSW, Australia; Heart Research Institute, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia.
⁴ Heart Research Institute, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia; Concord Hospital Cardiology, Concord Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.

PMID: 28623064
DOI: 10.1016/j.hlc.2017.05.118

Abstract

Atrial fibrillation (AF) is the most common cardiac arrhythmia, with a lifetime risk of one in four of developing AF over the age of 40 years. Around 40% of patients are asymptomatic, which is of concern as AF is a major risk factor for stroke. Early detection and appropriate management reduces stroke risk by two-thirds. Atrial fibrillation screening is now recommended in international guidelines, but there are some common arguments against screening. Overall, to be of value any screening program must fulfil the World Health Organization (WHO) Wilson and Jungner criteria for screening programs. In this paper we address the common arguments, and determine if AF screening fulfils the WHO criteria.

Keywords: Atrial fibrillation; Screening; Technology.

Copyright © 2017 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

Publication types

Review

MeSH terms

Atrial Fibrillation / diagnosis
Atrial Fibrillation / epidemiology
Early Diagnosis*
Electrocardiography
Global Health
Humans
Mass Screening*
Morbidity / trends
Risk Factors