Screening for Atrial Fibrillation in Belgium: a multicentre trial

Abstract

Screening for Atrial Fibrillation (AF) in Belgium: a multicentre trial Claes Neree, Goethals Marnix, Goethals Peter, Mairesse Georges, Schwagten Bruno, Nuyens Dieter, Schrooten Ward, Vijgen Johan

Introduction Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. The estimated prevalence is 0.4-1% in the general population, increasing with age to 8% in those older than 80y - . Epidemiological data of this arrhythmia in Belgium are scarce. It is important to screen for AF because patients with AF have a 5 times more risk for an ischemic stroke . The CHA2DS2-VASscore calculates the risk for stroke in those patients, a score ≥2 necessitate a therapy with anticoagulants . Methods Patients above 40 years were invited through different channels (TV, radio, journals, website, posters, leaflets) for a free screening in 69 hospitals allocated over Belgium during one week. After filling in a question on their personal history of AF, they had to fill in a questionnaire about their CHAD2-score. Afterwards a one channel ECG was taken using a versatile Heart Scan Device (Omron HCG-801-E©) by a trained nurse or a physician. If the ECG was positive for AF the patient was referred to their physician for follow-up. An Access database was constructed to collect the data and statistics were done in SPSS. Results 11.550 patients were screened. 38% are male and 62% are female with a mean age of 59y (+/-SD 11). 860 patients declared a history of AF (7.4%), 10.188 had no history of AF and in 502 the history was missing. 229 (1.9%) of the total population had AF on the one lead ECG where 148 were newly detected. According the CHADS2 68 patients had a score of 0, 70 of 1 and 91 of ≥2. For the CHA2DS2-VASscore the distribution was as follows: 14 patients with 0, 46 with 1 and 169 with ≥2. Conclusion Screening campaigns are feasible and able to detect 2% of patients with AF. A significant proportion of these patients are at risk for trombo-embolic event. Go AS, Hylek EM, Philips KA et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhytm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001;285:2370-5. Furberg CD, Psaty BM, Manolio TA, et al. Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study). Am J Cardiol 1994; 7:236-41. Wolf PA, Abbott RD, Kannel WB. Atrial Fibrillation as an independent risk factor for stroke: teh Framingham Study. Stroke 1991;22:983-8. Lip G, Pisters R, Crijns H. Refining clinical risk stratification using a novel risk factor based approach: The Euro Heart Survey on Atrial Fibrillation. Chest 2010;137:263-72.