Should we screen for atrial fibrillation?

Lown, Mark; Moran, Patrick

doi:10.1136/bmj.l43

Cited by 18 publications

(19 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[2] There has been increased interest in detecting AF due to its increased incidence and the possibility to prevent AF-related strokes. [3] Anticoagulation treatment using warfarin or direct oral anticoagulants is effective in reducing the risk of AF-related stroke by approximately two-thirds and can provide a 10% reduction in overall mortality. [4] Screening for AF has been the subject of much recent debate by expert committees.…”

Section: Introductionmentioning

confidence: 99%

“…[4] Screening for AF has been the subject of much recent debate by expert committees. [3] There has been recent interest in the use of consumer devices for the detection of arrhythmias including AF. [5,6] Wrist-worn heart-rate sensors that measure heart rate using Light Emitting Diodes (LEDs) have become increasingly popular but their accuracy has been questioned and some manufacturers advise the heart rate measurement should be considered an estimate and suggest using a chest heart rate sensor for increased accuracy.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Machine learning detection of Atrial Fibrillation using wearable technology

Lown

Brown

et al. 2020

PLoS ONE

Self Cite

View full text Add to dashboard Cite

BackgroundAtrial Fibrillation is the most common arrhythmia worldwide with a global age adjusted prevalence of 0.5% in 2010. Anticoagulation treatment using warfarin or direct oral anticoagulants is effective in reducing the risk of AF-related stroke by approximately two-thirds and can provide a 10% reduction in overall mortality. There has been increased interest in detecting AF due to its increased incidence and the possibility to prevent AF-related strokes. Inexpensive consumer devices which measure the ECG may have the potential to accurately detect AF but do not generally incorporate diagnostic algorithms. Machine learning algorithms have the potential to improve patient outcomes particularly where diagnoses are made from large volumes or complex patterns of data such as in AF. OPEN ACCESS Citation: Lown M, Brown M, Brown C, Yue AM, Shah BN, Corbett SJ, et al. (2020) Machine learning detection of Atrial Fibrillation using wearable technology. PLoS ONE 15(1): e0227401.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Machine learning detection of Atrial Fibrillation using wearable technology

Lown

Brown

et al. 2020

PLoS ONE

Self Cite

View full text Add to dashboard Cite

show abstract

“…More recent updates suggest consideration of economic implications, quality assurance and informed choice alongside equity and access of screening to the entire target population [7]. This is an important consideration and one yet to achieve consensus in terms of AF screening [13].…”

Section: Screeningmentioning

confidence: 99%

Screening for Atrial Fibrillation and the Role of Digital Health Technologies

Richardson¹,

Hall²,

Mitchell³

2020

Epidemiology and Treatment of Atrial Fibrillation

View full text Add to dashboard Cite

Atrial fibrillation is the commonest clinical arrhythmia and a leading cause of hospital admission, morbidity and mortality. New digital health technologies are now allowing patients and the general population to identify heart rhythm abnormalities before any encounter with a medical professional. This chapter will include an overview of the prevalence of atrial fibrillation and explore the current recommendations on methods for arrhythmia screening. We discuss different risk factors as well as physiological and structural markers for atrial fibrillation onset. We explore in detail the application of novel digital health technologies such as wearables, watches and mobile devices which may have an impact on screening detection rates. The article concludes with a discussion about how to manage patients with screen detected atrial fibrillation.

show abstract

“…2 Across England, it is estimated that 425 000 people are living with undiagnosed AF, 3 and there has been much recent debate about screening for AF. 4 The European Cardiac Society currently recommends opportunistic screening in patients aged >65 and consideration of systematic screening in patients aged >75 or in those at higher stroke risk. 5 No country has yet implemented a systematic screening programme although National Health Service (NHS) England has commissioned pilot AF screening schemes in pharmacies and in influenza clinics to 'test the treatments and care models of tomorrow.…”

Section: Introductionmentioning

confidence: 99%

Patients’ views about screening for atrial fibrillation (AF): a qualitative study in primary care

et al. 2020

Self Cite

View full text Add to dashboard Cite

ObjectivesThere has been increased interest in screening for atrial fibrillation (AF) with commissioned pilot schemes, ongoing large clinical trials and the emergence of inexpensive consumer single-lead ECG devices that can be used to detect AF. This qualitative study aimed to explore patients’ views and understanding of AF and AF screening to determine acceptability and inform future recommendations.SettingA single primary care practice in Hampshire, UK.Participants15 participants (11 female) were interviewed from primary care who had taken part in an AF screening trial. A semistructured interview guide was used flexibly to enable the interviewer to explore any relevant topics raised by the participants. Interviews were recorded, transcribed verbatim and analysed using inductive thematic analysis.ResultsParticipants generally had an incomplete understanding of AF and conflated it with other heart problems or with raised blood pressure. With regards to potential drawbacks from screening, some participants considered anxiety and the cost of implementation, but none acknowledged potential harms associated with screening such as side effects of anticoagulation treatment or the risk of further investigations. The screening was generally well accepted, and participants were generally in favour of engaging with prolonged screening.ConclusionsOur study highlights that there may be poor understanding (of both the nature of AF and potential negatives of screening) among patients who have been screened for AF. Further work is required to determine if resources including decision aids can address this important knowledge gap and improve clinical informed consent for AF screening.Trial registration numberISRCTN 17495003.

show abstract

Should we screen for atrial fibrillation?

Abstract: Current evidence is sufficient to justify a national screening programme, argues Mark Lown, but Patrick Moran thinks there are too many unanswered questions and evidence from randomised trials is needed to avoid overdiagnosis

Cited by 18 publications

References 19 publications

Machine learning detection of Atrial Fibrillation using wearable technology

Machine learning detection of Atrial Fibrillation using wearable technology

Screening for Atrial Fibrillation and the Role of Digital Health Technologies

Patients’ views about screening for atrial fibrillation (AF): a qualitative study in primary care

Contact Info

Product

Resources

About