Opportunistic screening for atrial fibrillation versus detecting symptomatic patients aged 65 years and older: A cluster-controlled clinical trial

Blanco, Virginia González; Torres, Luis Ángel Pérula de; Rioboó, Enrique Martín; Adell, Miguel Ángel Martínez; Rejano, Juan Manuel Parras; González-Lama, Jesús; Moruno, Javier Ruiz; Álvarez, Remedios Martín; Garcı́a, J.A.; Castroviejo, Joaquín Ruiz de; Villalobos, Ana Roldán; Moral, Roger Ruiz

doi:10.1016/j.medcle.2016.07.029

Cited by 4 publications

(2 citation statements)

References 28 publications

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“…El estudio DOFA, ensayo clínico multicéntrico realizado en atención primaria en España 283 , sugiere que, en condiciones de práctica real, una búsqueda activa, a través de la palpación del pulso, de FA en pacientes de edad > 65 años con síntomas o signos indicativos es una estrategia más eficaz que el cribado oportunista en pacientes asintomáticos.…”

Section: Evidencia Científicaunclassified

Recomendaciones preventivas cardiovasculares. Actualización PAPPS 2022

Orozco‐Beltrán

Cuixart²,

Banegas

et al. 2022

Atención Primaria

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Section: Evidencia Científicaunclassified

Recomendaciones preventivas cardiovasculares. Actualización PAPPS 2022

Orozco‐Beltrán

Cuixart²,

Banegas

et al. 2022

Atención Primaria

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“…Opportunistic strategies are most often used in the setting of primary prevention. 21–25 Conversely, systematic strategies have been described both in the setting of primary 22,26,27 and secondary prevention 15,28–30 of ischemic stroke.…”

Section: How Should We Select the Right Detection Tool And Monitoringmentioning

confidence: 99%

Long-term monitoring to detect atrial fibrillation with the indwelling implantable cardiac monitors

Sanna

2018

International Journal of Stroke

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An increasing number of detection tools are available and several detection strategies have been described to pursue the diagnosis of atrial fibrillation to prevent ischemic stroke. Monitoring tools include standard electrocardiography, snapshot single-lead recordings with professional or personal devices (e.g. smartphone-based), Holter monitor, external devices with long-term recording capabilities, and cardiac implantable electronic devices, including pacemakers, implantable cardioverter defibrillators and insertable cardiac monitors. Insertable cardiac monitors have shown high sensitivity and specificity for the detection of atrial fibrillation, allow up to three years of continuous monitoring, do not require cooperation of the patient, are well tolerated, have a short device-related time delay between detection of atrial fibrillation and notification to the physician, provide information on atrial fibrillation burden and are minimally invasive. On the other hand, insertable cardiac monitors require a considerable use of resources to process the recordings and have a significant initial cost. Studies conducted with insertable cardiac monitors on patients with prior stroke and on patients with risk factors for stroke but no prior cerebrovascular events or atrial fibrillation have consistently shown a measurable incidence of atrial fibrillation at follow-up. However, the effectiveness of oral anticoagulations in reducing the incidence of ischemic stroke in patients with atrial fibrillation lasting less than 24 h, though reasonable, is currently unproven. The future of atrial fibrillation detection tools and atrial fibrillation detection strategies will be influenced by ongoing studies exploring whether oral anticoagulations reduce the incidence of stroke in patients with atrial fibrillation burden lower than 24 h.

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