This is not the most recent version of the article. View current version (3 JUN 2016)

Intervention Review

You have free access to this content

Effectiveness of systematic screening for the detection of atrial fibrillation

  1. Patrick S Moran1,*,
  2. Martin J Flattery1,
  3. Conor Teljeur1,
  4. Mairin Ryan1,
  5. Susan M Smith2

Editorial Group: Cochrane Heart Group

Published Online: 30 APR 2013

Assessed as up-to-date: 22 AUG 2012

DOI: 10.1002/14651858.CD009586.pub2


How to Cite

Moran PS, Flattery MJ, Teljeur C, Ryan M, Smith SM. Effectiveness of systematic screening for the detection of atrial fibrillation. Cochrane Database of Systematic Reviews 2013, Issue 4. Art. No.: CD009586. DOI: 10.1002/14651858.CD009586.pub2.

Author Information

  1. 1

    Health Information and Quality Authority, Health Technology Assessment, Dublin, Dublin, Ireland

  2. 2

    Royal College of Surgeons, Department of General Practice, Dublin, Ireland

*Patrick S Moran, Health Technology Assessment, Health Information and Quality Authority, George's Court, George's Lane, Smithfield, Dublin, Dublin, D7, Ireland. patrick.s.moran@gmail.com.

Publication History

  1. Publication Status: New
  2. Published Online: 30 APR 2013

SEARCH

This is not the most recent version of the article. View current version (03 JUN 2016)

References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
Hobbs 2005 {published data only}
  • Fitzmaurice DA, Hobbs FD, Jowett S, Mant J, Murray ET, Holder R, et al. Screening versus routine practice in detection of atrial fibrillation in patients aged 65 or over: cluster randomised controlled trial. BMJ 2007;335(7616):383.
  • Hobbs FDR, Fitzmaurice DA, Jowett S, Mant J, Murray E, Bryan S, et al. A randomised controlled trial and cost-effectiveness study of systematic screening (targeted and total population screening) versus routine practice for the detection of atrial fibrillation in people aged 65 and over. The SAFE study. Health Technology Assessment 2005;9:40.
  • Mant J, Fitzmaurice DA, Hobbs FD, Jowett S, Murray ET, Holder R, et al. Accuracy of diagnosing atrial fibrillation on electrocardiogram by primary care practitioners and interpretative diagnostic software: analysis of data from screening for atrial fibrillation in the elderly (SAFE) trial. BMJ 2007;335(7616):380.
  • Swancutt D, Hobbs R, Fitzmaurice D, Mant J, Murray E, Jowett S, et al. A randomised controlled trial and cost effectiveness study of systematic screening (targeted and total population screening) versus routine practice for the detection of atrial fibrillation in the over 65s: (SAFE) [ISRCTN19633732]. BMC cardiovascular disorders 2004;4:12.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
ACTRN12612000406808 {published data only}
  • Freedman B. Screening Education And Recognition in Community pHarmacies of Atrial Fibrillation to prevent stroke (SEARCH-AF). Australian New Zealand Clinical Trials Registry 2012;Trial Identifier: ACTRN12612000406808.
Baxter 1998 {published data only}
Claes 2012 {published data only}
  • Claes N, Van Laethem C, Goethals M, Goethals P, Mairesse G, Schwagten B, et al. Prevalence of atrial fibrillation in adults participating in a large-scale voluntary screening programme in Belgium. Acta Cardiologica 2012;67(3):273-8.
DeRuijter 2008 {published data only}
  • De Ruijter W, Assendelft WJ, Macfarlane PW, Westendorp RG, Gussekloo J. The additional value of routine electrocardiograms in cardiovascular risk management of older people. Scandinavian Journal of Primary Health Care 2008;26(3):147-53.
Ho 2004 {published data only}
  • Ho SF, O'Mahony MS, Steward JA, Burr ML, Buchalter M. Left ventricular systolic dysfunction and atrial fibrillation in older people in the community--a need for screening?. Age and Ageing 2004;33(5):488-92.
Hoefman 2005 {published data only}
  • Hoefman E, van Weert HC, Reitsma JB, Koster RW, Bindels PJ. Diagnostic yield of patient-activated loop recorders for detecting heart rhythm abnormalities in general practice: a randomised clinical trial. Family Practice 2005;22(5):478-84.
Johnson 2010 {published data only}
  • Johnson BJ, Urrutia V. Stroke risk factor screening in an inner city public market - A description of the population - A better target for screening/education efforts. Stroke 2010;41:e200-53.
Maeda 2004 {published data only}
Marek 2011 {published data only}
  • Marek J, Bufalino V, Davis J, Marek K, Gami A, Stephan W, et al. Feasibility and findings of large-scale electrocardiographic screening in young adults: data from 32,561 subjects. Heart Rhythm 2011;8(10):1555-9.
Morgan 2002 {published data only}
  • Morgan S, Mant D. Randomised trial of two approaches to screening for atrial fibrillation in UK general practice. The British Journal of General Practice 2002;52(478):373-4, 377-80.
Munschauer 1999 {published data only}
  • Munschauer FE, Hens MM, Priore RL, Stolarski E, Buffamonte S, Carlin A, et al. Screening for atrial fibrillation in the community: a multicenter validation trial. Journal of Stroke and Cerebrovascular Diseases 1999;8(2):99-103.
Somerville 2000 {published data only}
  • Somerville S, Somerville J, Croft P, Lewis M. Atrial fibrillation: a comparison of methods to identify cases in general practice. The British Journal of General Practice 2000;50(458):727-9.
Sudlow 1998 {published data only}
Wheeldon 1998 {published data only}
Wright 2007 {published data only}
  • Wright J, Bibby J, Eastham J, Harrison S, McGeorge M, Patterson C, et al. Multifaceted implementation of stroke prevention guidelines in primary care: cluster-randomised evaluation of clinical and cost effectiveness. Quality & Safety in Health Care 2007;16(1):51-9.

References to ongoing studies

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
NCT01291953 {published and unpublished data}
  • NCT01291953. Effectiveness of Early Detection of Atrial Fibrillation (FAMDAP). http://www.clinicaltrials.gov/ct2/show/NCT01291953 (accessed 24/01/2013).
NCT01593553 {published data only}
  • NCT01593553. Systematic ECG Screening for Atrial Fibrillation Among 75 Year Old Subjects in the Region of Stockholm and Halland, Sweden. http://www.clinicaltrials.gov/ct2/show/NCT01593553?term=NCT01593553&rank=1 (accessed 24/01/2013).

Additional references

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to ongoing studies
  4. Additional references
Barratt 2002
Benjamin 1994
  • Benjamin EJ, Levy D, Vaziri SM, D'Agostino RB, Belanger AJ, Wolf PA. Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA 1994;271(11):840-4.
Benjamin 1998
Bilato 2009
  • Bilato C, Corti MC, Baggio G, Rampazzo D, Cutolo A, Iliceto S, Crepaldi G. Prevalence, functional impact and mortality of atrial fibrillation in an older Italian population (from the PRO.V.A Study). American Journal of Cardiology 2009;104:1092-7.
Caldwell 2012
  • Caldwell JC, Borbas Z, Donald A, Clifford A, Bolger L, Black A, et al. Simplified electrocardiogram sampling maintains high diagnostic capability for atrial fibrillation: implications for opportunistic atrial fibrillation screening in primary care. Europace 2012;14(2):191-6.
CDC 2001
  • CDC. Utilization of Ambulatory Medical Care by Women: United States, 1997-98. Series Report 13, No. 149. 51 pp. http://www.cdc.gov/nchs/data/series/sr_13/sr13_149.pdf 2001.
Cooke 2006
  • Cooke G, Doust J, Sanders S. Is pulse palpation helpful in detecting atrial fibrillation? A systematic review. Journal of Family Practice 2006;55(2):130-4.
Cullinane 1998
  • Cullinane M, Wainwright R, Brown A, Monaghan M, Markus HS. Asymptomatic embolization in subjects with atrial fibrillation not taking anticoagulants: a prospective study. Stroke 1998;29(9):1810-5.
EPOC 2011
  • Cochrane Effective Practice and Organisation of Care Group. EPOC resources for review authors. http://epoc.cochrane.org/epoc-resources-review-authors 2011.
ESC 2010
  • European Heart Rhythm Association, European Association for Cardio-Thoracic Surgery, Camm AJ, Kirchhof P, Lip GY, Schotten U, Savelieva I, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). European Heart Journal 2010;31(19):2369-429.
Feinberg 1995
  • Feinberg WM, Blackshear JL, Laupacis A,  Kronmal R. Hart RG. Prevalence, age distribution, and gender of patients with atrial fibrillation. Analysis and implications. Archives of Internal Medicine 1995;155(5):469–73.
Fitzmaurice 2007
  • Fitzmaurice DA, Hobbs FD, Jowett S, Mant J, Murray ET, Holder R, et al. Screening versus routine practice in detection of atrial fibrillation in patients aged 65 or over: cluster randomised controlled trial. BMJ 2007;335(7616):383.
Flegel 1987
  • Flegel KM, Shipley MJ, Rose G. Risk of stroke in non-rheumatic atrial fibrillation [published erratum appears in Lancet 1987;1:878]. Lancet 1987;1:526–9.
Fletcher 2005
  • Fletcher RH, Fletcher SW. Clinical epidemiology: the essentials. Lippincott Williams & Wilkins; Fourth edition, 2005.
Frazier 1990
  • Frazier TG, Cummings PD. Motivational factors for participation in breast cancer screening. Journal of Cancer Education 1990;5(1):51-4.
Freiberg 1997
Friberg 2010
Friedemann-Sanchez 2007
Furberg 1994
  • Furberg CD, Psaty BM, Manolio TA, Gardin JM, Smith VE, Rautaharju PM. Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study). American Journal of Cardiology 1994;74:236–41.
Fuster 2006
  • Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of CardiologyCommittee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation). Journal of the American College of Cardiology 2006;48:149-246.
Go 2001
  • Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001;285:2370–5.
Goroll 1995
  • Goroll AH, May LA, Mulley AG. Primary Care Medicine. 3rd Edition. Philadelphia: Lippincott, 1995:13-6.
Gowd 2012
Grogan 1992
  • Grogan M, Smith HC, Gersh BJ, Wood DL. Left ventricular dysfunction due to atrial fibrillation in patients initially believed to have idiopathic dilated cardiomyopathy. American Journal of Cardiology 1992;69(19):1570-3.
Harris 2011
  • Harris R, Sawaya GF, Moyer VA, Calonge N. Reconsidering the criteria for evaluating proposed screening programs: Reflections from 4 current and former members of the U.S. Preventive Services Task Force. Epidemiologic Reviews 2011;33:20-35.
Harris 2012
  • Harris K, Edwards D, Mant J. How can we best detect atrial fibrillation?. The Journal of the Royal College of Physicians of Edinburgh 2012;42 Suppl 18:5-22.
Hart 2007
  • Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Annals of Internal Medicine 2007;146(12):857-67.
Heeringa 2006
  • Heeringa J, van de Kuip DAM, Hofman A, Kors JA, van Herpen G, Stricker BHCh, et al. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. European Heart Journal 2006;27:949-53.
Higgins 2011
  • Higgins JPT, Green S (editors). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 [updated March 2011]. The Cochrane Collaboration 2011; Vol. Available from www.cochrane-handbook.org.
Hohnloser 2007
  • Hohnloser SH, Pajitnev D, Pogue J, Healey JS, Pfeffer MA, Yusuf S, et al. Incidence of stroke in paroxysmal versus sustained atrial fibrillation in patients taking oral anticoagulation or combined antiplatelet therapy: an ACTIVE W Substudy. Journal of the American College of Cardiology 2007;50(22):2156-61.
Jepson 2000
  • Jepson R, Clegg A, Forbes C, Lewis R, Sowden A, Kleijnen J. The determinants of screening uptake and interventions for increasing uptake: a systematic review. Health Technology Assessment 2000;4(14):1-133.
Kannel 1983
Krahn 1995
  • Krahn AD, Manfreda J, Tate RB, Mathewson FA, Cuddy TE. The natural history of atrial fibrillation: incidence, risk factors, and prognosis in the Manitoba Follow-Up Study. American Journal of Medicine 1995;98:476–84.
Lefebvre 2011
  • Lefebvre C, Manheimer E, Glanville J. Chapter 6: Searching for studies. In: Higgins JPT, Green S editor(s). Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0 (updated March 2011). The Cochrane Collaboration, 2011. Available from www.cochrane-handbook.org.
Levy 2003
  • Levy S, Camm AJ, Saksena S, Aliot E, Breithardt G, Crijns H, et al. International consensus on nomenclature and classification of atrial fibrillation; a collaborative project of the Working Group on Arrhythmias and the Working Group on Cardiac Pacing of the European Society of Cardiology and the North American Society of Pacing and Electrophysiology. Europace 2003;5:119–22.
Lin 1995
Lin 1996
Lip 2012
  • Lip GY, Brechin CM, Lane DA. The global burden of atrial fibrillation and stroke: A systematic review of the epidemiology of atrial fibrillation in regions outside North America and Europe. Chest 2012;142(6):1489-98.
Mant 2007
  • Mant J, Fitzmaurice DA, Hobbs FD, Jowett S, Murray ET, Holder R, et al. Accuracy of diagnosing atrial fibrillation on electrocardiogram by primary care practitioners and interpretative diagnostic software: analysis of data from screening for atrial fibrillation in the elderly (SAFE) trial. BMJ 2007;335(7616):380.
McGregor 2006
  • McGregor P, Nolan A, Nolan B, O'Neill, C. A comparison of GP visiting in Northern Ireland and the Republic of Ireland. ESRI Research Programme on Health Services, Health Inequalities and Health and Social Gain 2006;Working paper No. 22.
NCCCC 2006
  • National Collaborating Centre for Chronic Conditions. Atrial fibrillation: national clinical guideline for management in primary and secondary care. London: Royal College of Physicians 2006.
Ogilvie 2010
Ott 1997
  • Ott A, Breteler MM, de Bruyne MC, van Harskamp F, Grobbee DE, Hofman A. Atrial fibrillation and dementia in a population-based study. The Rotterdam Study. Stroke 1997 Feb;28(2):316-21.
Parkin 2008
Peate 2004
  • Peate I. Men's attitudes towards health and the implications for nursing care. British Journal of Nursing 2004;13(9):540-5.
Psaty 1997
Savelieva 2000
Stewart 2001
  • Stewart S, MacIntyre K, MacLeod MM, Bailey AE, Capewell S, McMurray JJ. Trends in hospital activity,morbidity and case fatality related to atrial fibrillation in Scotland,1986–1996. European Heart Journal 2001;22(8):693–701.
Stewart 2002
  • Stewart S, Hart CL, Hole DJ, McMurray JJ. A population-based study of the long-term risks associated with atrial fibrillation: 20-year follow-up of the Renfrew/Paisley study. American Journal of Medicine 2001;113(5):359-64.
Swancutt 2004
  • Swancutt D, Hobbs R, Fitzmaurice D, Mant J, Murray E, Jowett S, et al. A randomised controlled trial and cost effectiveness study of systematic screening (targeted and total population screening) versus routine practice for the detection of atrial fibrillation in the over 65s: (SAFE) [ISRCTN19633732]. BMC Cardiovascular Disorders 2004;4:12.
Wardle 2005
Wattigney 2003
  • Wattigney WA, Mensah GA, Croft JB. Increasing trends in hospitalization for atrial fibrillation in the United States, 1985 through 1999:implications for primary prevention. Circulation 2003;108:711–6.
Weller 2009
Wilson Jungner 1968
  • Wilson JMG, Jungner G. Principles and practice of screening for disease. WHO, 1968.
Wolf 1983
Wolf 1987
Wolf 1991
Wyse 2002
  • Wyse DG, Waldo AL. DiMarco JP, Domanski MJ, Rosenberg Y, Schron EB, et al. A comparison of rate control and rhythm control in patients with atrial fibrillation. New England Journal of Medicine 2002;347(23):1825-33.