Prevalence of silent atrial fibrillation in high-risk patients - preliminary results from a European three-country handheld ECG-screening study

Abstract

Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Helsefonden Lilly and Herbert Hansens Foundation Introduction Patients with atrial fibrillation (AF) should in most cases be offered prophylactic anticoagulation treatment to prevent a stroke. However, the arrhythmia can appear without symptoms, so-called silent AF. Even without symptoms AF constitutes a risk for stroke. Purpose To screen high-risk patients with diabetes type 2 (DMII) or heart failure (CHF) for silent AF. Methods We included patients > 64 years with either DMII or CHF from out-patient clinics and local health centers. Exclusion criteria were known AF, anticoagulation treatment, recent stroke, or an implanted pacemaker or ICD. Patients were recruited from a total of eleven study centers in three countries. All underwent 14-days of intermittent ECG screening with a handheld ECG recording four times each day; the recordings were digitally stored. AF was diagnosed in cases of irregular heart rhythm and absence of P waves on at least one recording (thirty seconds) or on at least two recordings for a minimum of ten seconds. Results In total, 813 patients were included, 541 of these with DMII. The mean age was 73,4 years ± 5,8 SD, 40,7% of the patients were female. In the DMII group thirteen patients (2.4%) were diagnosed with silent AF and offered anticoagulation. In the CHF group six (2.2%) patients had diagnosed silent AF on the handheld ECG. The prevalence of AF increased with increasing age, see Table 1. Thus, in the youngest group AF was diagnosed in 1.3% of the patients compared to 3.9 % in the age group 75 years or older. Conclusions Screening for silent AF in high-risk patients with DMII or CHF seems worthwhile, especially in patients 75 years or older. Abstract Figure. ECG with atrial fibrillation