Cargando…

Opportunistic screening for atrial fibrillation in a real-life setting in general practice in Denmark—The Atrial Fibrillation Found On Routine Detection (AFFORD) non-interventional study

Atrial fibrillation (AF) is a chronic disease with an incidence increasing steeply by age and affecting more than 11 million patients in Europe and the United States. Diagnosing AF is essential for the prevention of stroke by oral anticoagulation. Opportunistic screening for AF in patients ≥65 years...

Descripción completa

Detalles Bibliográficos
Autores principales: Hald, Jonas, Poulsen, Peter Bo, Qvist, Ina, Holm, Lisbeth, Wedell-Wedellsborg, Dorte, Dybro, Lars, Frost, Lars
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5683635/
https://www.ncbi.nlm.nih.gov/pubmed/29131836
http://dx.doi.org/10.1371/journal.pone.0188086
_version_ 1783278329495814144
author Hald, Jonas
Poulsen, Peter Bo
Qvist, Ina
Holm, Lisbeth
Wedell-Wedellsborg, Dorte
Dybro, Lars
Frost, Lars
author_facet Hald, Jonas
Poulsen, Peter Bo
Qvist, Ina
Holm, Lisbeth
Wedell-Wedellsborg, Dorte
Dybro, Lars
Frost, Lars
author_sort Hald, Jonas
collection PubMed
description Atrial fibrillation (AF) is a chronic disease with an incidence increasing steeply by age and affecting more than 11 million patients in Europe and the United States. Diagnosing AF is essential for the prevention of stroke by oral anticoagulation. Opportunistic screening for AF in patients ≥65 years of age is recommended by the European and Danish Societies of Cardiology. The study aim was to examine the detection rate of AF in consecutively screened patients in the primary care setting in Denmark. In an open, non-interventional, cluster, multicenter, cross-sectional, observational study patients ≥65 years of age entering consecutively into general practice clinics were invited to nurse-assisted opportunistic screening for AF. The General Practice (GP) clinics participating were randomized to patient inclusion in three age groups: 65–74, 75–84, and ≥85 years respectively. All patients underwent pulse palpation followed by 12-led electrocardiogram in case of irregular pulse. Two cardiologists validated all electrocardiogram examinations. Forty-nine general practice clinics recruited in total 970 patients split into three age groups; 480 patients (65–74 years), 372 (75–84 years), and 118 patients ≥85 years of age. Co-morbidities increased by age with hypertension being most frequent. Eighty-seven patients (9%) were detected with an irregular pulse, representing 4.4%, 10.5% and 22.9%, respectively in the three age groups. Assessment of electrocardiograms by the GP showed suspicion of AF in 13 patients with final verification of electrocardiograms by cardiologists revealing 10 AF-patients. The highest detection rate of AF was found in the ≥85 age group (3.39%) followed by the 65–74 age group (0.83%) and the 75–84 age group (0.54%). Opportunistic screening of AF in primary care is feasible and do result in the detection of new AF-patients. Close collaboration with cardiologists is advisable to avoid false positive screening results.
format Online
Article
Text
id pubmed-5683635
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-56836352017-11-30 Opportunistic screening for atrial fibrillation in a real-life setting in general practice in Denmark—The Atrial Fibrillation Found On Routine Detection (AFFORD) non-interventional study Hald, Jonas Poulsen, Peter Bo Qvist, Ina Holm, Lisbeth Wedell-Wedellsborg, Dorte Dybro, Lars Frost, Lars PLoS One Research Article Atrial fibrillation (AF) is a chronic disease with an incidence increasing steeply by age and affecting more than 11 million patients in Europe and the United States. Diagnosing AF is essential for the prevention of stroke by oral anticoagulation. Opportunistic screening for AF in patients ≥65 years of age is recommended by the European and Danish Societies of Cardiology. The study aim was to examine the detection rate of AF in consecutively screened patients in the primary care setting in Denmark. In an open, non-interventional, cluster, multicenter, cross-sectional, observational study patients ≥65 years of age entering consecutively into general practice clinics were invited to nurse-assisted opportunistic screening for AF. The General Practice (GP) clinics participating were randomized to patient inclusion in three age groups: 65–74, 75–84, and ≥85 years respectively. All patients underwent pulse palpation followed by 12-led electrocardiogram in case of irregular pulse. Two cardiologists validated all electrocardiogram examinations. Forty-nine general practice clinics recruited in total 970 patients split into three age groups; 480 patients (65–74 years), 372 (75–84 years), and 118 patients ≥85 years of age. Co-morbidities increased by age with hypertension being most frequent. Eighty-seven patients (9%) were detected with an irregular pulse, representing 4.4%, 10.5% and 22.9%, respectively in the three age groups. Assessment of electrocardiograms by the GP showed suspicion of AF in 13 patients with final verification of electrocardiograms by cardiologists revealing 10 AF-patients. The highest detection rate of AF was found in the ≥85 age group (3.39%) followed by the 65–74 age group (0.83%) and the 75–84 age group (0.54%). Opportunistic screening of AF in primary care is feasible and do result in the detection of new AF-patients. Close collaboration with cardiologists is advisable to avoid false positive screening results. Public Library of Science 2017-11-13 /pmc/articles/PMC5683635/ /pubmed/29131836 http://dx.doi.org/10.1371/journal.pone.0188086 Text en © 2017 Hald et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Hald, Jonas
Poulsen, Peter Bo
Qvist, Ina
Holm, Lisbeth
Wedell-Wedellsborg, Dorte
Dybro, Lars
Frost, Lars
Opportunistic screening for atrial fibrillation in a real-life setting in general practice in Denmark—The Atrial Fibrillation Found On Routine Detection (AFFORD) non-interventional study
title Opportunistic screening for atrial fibrillation in a real-life setting in general practice in Denmark—The Atrial Fibrillation Found On Routine Detection (AFFORD) non-interventional study
title_full Opportunistic screening for atrial fibrillation in a real-life setting in general practice in Denmark—The Atrial Fibrillation Found On Routine Detection (AFFORD) non-interventional study
title_fullStr Opportunistic screening for atrial fibrillation in a real-life setting in general practice in Denmark—The Atrial Fibrillation Found On Routine Detection (AFFORD) non-interventional study
title_full_unstemmed Opportunistic screening for atrial fibrillation in a real-life setting in general practice in Denmark—The Atrial Fibrillation Found On Routine Detection (AFFORD) non-interventional study
title_short Opportunistic screening for atrial fibrillation in a real-life setting in general practice in Denmark—The Atrial Fibrillation Found On Routine Detection (AFFORD) non-interventional study
title_sort opportunistic screening for atrial fibrillation in a real-life setting in general practice in denmark—the atrial fibrillation found on routine detection (afford) non-interventional study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5683635/
https://www.ncbi.nlm.nih.gov/pubmed/29131836
http://dx.doi.org/10.1371/journal.pone.0188086
work_keys_str_mv AT haldjonas opportunisticscreeningforatrialfibrillationinareallifesettingingeneralpracticeindenmarktheatrialfibrillationfoundonroutinedetectionaffordnoninterventionalstudy
AT poulsenpeterbo opportunisticscreeningforatrialfibrillationinareallifesettingingeneralpracticeindenmarktheatrialfibrillationfoundonroutinedetectionaffordnoninterventionalstudy
AT qvistina opportunisticscreeningforatrialfibrillationinareallifesettingingeneralpracticeindenmarktheatrialfibrillationfoundonroutinedetectionaffordnoninterventionalstudy
AT holmlisbeth opportunisticscreeningforatrialfibrillationinareallifesettingingeneralpracticeindenmarktheatrialfibrillationfoundonroutinedetectionaffordnoninterventionalstudy
AT wedellwedellsborgdorte opportunisticscreeningforatrialfibrillationinareallifesettingingeneralpracticeindenmarktheatrialfibrillationfoundonroutinedetectionaffordnoninterventionalstudy
AT dybrolars opportunisticscreeningforatrialfibrillationinareallifesettingingeneralpracticeindenmarktheatrialfibrillationfoundonroutinedetectionaffordnoninterventionalstudy
AT frostlars opportunisticscreeningforatrialfibrillationinareallifesettingingeneralpracticeindenmarktheatrialfibrillationfoundonroutinedetectionaffordnoninterventionalstudy