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How is atrial fibrillation detected in everyday healthcare? Results of a Dutch cohort study

BACKGROUND: Atrial fibrillation (AF) is a common arrhythmia with serious potential consequences when left untreated. For timely treatment, early detection is imperative. We explored how new AF is detected in patients aged ≥ 65 years in Dutch healthcare. METHODS: The study cohort consisted of 9526 pa...

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Autores principales: Verbiest-van Gurp, N., Uittenbogaart, S. B., van de Moosdijk, S. C. M., van Sprang, U. F., Knottnerus, J. A., Stoffers, H. E. J. H., Lucassen, W. A. M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Bohn Stafleu van Loghum 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9892390/
https://www.ncbi.nlm.nih.gov/pubmed/36048351
http://dx.doi.org/10.1007/s12471-022-01719-2
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author Verbiest-van Gurp, N.
Uittenbogaart, S. B.
van de Moosdijk, S. C. M.
van Sprang, U. F.
Knottnerus, J. A.
Stoffers, H. E. J. H.
Lucassen, W. A. M.
author_facet Verbiest-van Gurp, N.
Uittenbogaart, S. B.
van de Moosdijk, S. C. M.
van Sprang, U. F.
Knottnerus, J. A.
Stoffers, H. E. J. H.
Lucassen, W. A. M.
author_sort Verbiest-van Gurp, N.
collection PubMed
description BACKGROUND: Atrial fibrillation (AF) is a common arrhythmia with serious potential consequences when left untreated. For timely treatment, early detection is imperative. We explored how new AF is detected in patients aged ≥ 65 years in Dutch healthcare. METHODS: The study cohort consisted of 9526 patients from 49 Dutch general practices in the usual-care arm of the Detecting and Diagnosing Atrial Fibrillation study. We automatically extracted data from the electronic medical records and reviewed individual records of patients who developed AF. Patient selection started in 2015, and data collection ended in 2019. RESULTS: We included 258 patients with newly diagnosed AF. In 55.0% of the patients, the irregular heartbeat was first observed in general practice and in 16.3% in the cardiology department. Cardiologists diagnosed most cases (47.3%), followed by general practitioners (GPs; 33.7%). AF detection was triggered by symptoms in 64.7% of the patients and by previous stroke in 3.5%. Overall, patients aged 65–74 years more often presented with symptoms than those aged ≥ 75 years (73.5% vs 60.6%; p = 0.042). In 31.5% of the patients, AF was diagnosed incidentally (‘silent AF’). Silent-AF patients were on average 2 years older than symptomatic-AF patients. GPs less often diagnosed silent AF than symptomatic AF (21.0% vs 39.0%; p = 0.008), whereas physicians other than GPs or cardiologists more often diagnosed symptomatic AF than silent AF (34.6% vs 11.9%; p < 0.001). Most diagnoses were based on a 12-lead electrocardiogram (93.8%). CONCLUSION: Diagnosing AF is a multidisciplinary process. The irregular heartbeat was most often detected by the GP, but cardiologists diagnosed most cases. One-third of all newly diagnosed AF was silent. SUPPLEMENTARY INFORMATION: The online version of this article (10.1007/s12471-022-01719-2) contains supplementary material, which is available to authorized users.
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spelling pubmed-98923902023-02-03 How is atrial fibrillation detected in everyday healthcare? Results of a Dutch cohort study Verbiest-van Gurp, N. Uittenbogaart, S. B. van de Moosdijk, S. C. M. van Sprang, U. F. Knottnerus, J. A. Stoffers, H. E. J. H. Lucassen, W. A. M. Neth Heart J Original Article BACKGROUND: Atrial fibrillation (AF) is a common arrhythmia with serious potential consequences when left untreated. For timely treatment, early detection is imperative. We explored how new AF is detected in patients aged ≥ 65 years in Dutch healthcare. METHODS: The study cohort consisted of 9526 patients from 49 Dutch general practices in the usual-care arm of the Detecting and Diagnosing Atrial Fibrillation study. We automatically extracted data from the electronic medical records and reviewed individual records of patients who developed AF. Patient selection started in 2015, and data collection ended in 2019. RESULTS: We included 258 patients with newly diagnosed AF. In 55.0% of the patients, the irregular heartbeat was first observed in general practice and in 16.3% in the cardiology department. Cardiologists diagnosed most cases (47.3%), followed by general practitioners (GPs; 33.7%). AF detection was triggered by symptoms in 64.7% of the patients and by previous stroke in 3.5%. Overall, patients aged 65–74 years more often presented with symptoms than those aged ≥ 75 years (73.5% vs 60.6%; p = 0.042). In 31.5% of the patients, AF was diagnosed incidentally (‘silent AF’). Silent-AF patients were on average 2 years older than symptomatic-AF patients. GPs less often diagnosed silent AF than symptomatic AF (21.0% vs 39.0%; p = 0.008), whereas physicians other than GPs or cardiologists more often diagnosed symptomatic AF than silent AF (34.6% vs 11.9%; p < 0.001). Most diagnoses were based on a 12-lead electrocardiogram (93.8%). CONCLUSION: Diagnosing AF is a multidisciplinary process. The irregular heartbeat was most often detected by the GP, but cardiologists diagnosed most cases. One-third of all newly diagnosed AF was silent. SUPPLEMENTARY INFORMATION: The online version of this article (10.1007/s12471-022-01719-2) contains supplementary material, which is available to authorized users. Bohn Stafleu van Loghum 2022-09-01 2023-02 /pmc/articles/PMC9892390/ /pubmed/36048351 http://dx.doi.org/10.1007/s12471-022-01719-2 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Article
Verbiest-van Gurp, N.
Uittenbogaart, S. B.
van de Moosdijk, S. C. M.
van Sprang, U. F.
Knottnerus, J. A.
Stoffers, H. E. J. H.
Lucassen, W. A. M.
How is atrial fibrillation detected in everyday healthcare? Results of a Dutch cohort study
title How is atrial fibrillation detected in everyday healthcare? Results of a Dutch cohort study
title_full How is atrial fibrillation detected in everyday healthcare? Results of a Dutch cohort study
title_fullStr How is atrial fibrillation detected in everyday healthcare? Results of a Dutch cohort study
title_full_unstemmed How is atrial fibrillation detected in everyday healthcare? Results of a Dutch cohort study
title_short How is atrial fibrillation detected in everyday healthcare? Results of a Dutch cohort study
title_sort how is atrial fibrillation detected in everyday healthcare? results of a dutch cohort study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9892390/
https://www.ncbi.nlm.nih.gov/pubmed/36048351
http://dx.doi.org/10.1007/s12471-022-01719-2
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