Screening for AFib Could Reduce Stroke Risk in Elderly Adults

Screening for atrial fibrillation (AFib) in older adults (75-76-year-olds) may reduce the risk of stroke, severe bleeding and death, according to a study published in The Lancet.

“There has never really been a study that examines if it would be beneficial to screen for atrial fibrillation, which is why we wanted to investigate it,” says Dr. Emma Svennberg, cardiologist at the Karolinska University Hospital, Huddinge, and researcher at the Department of Medicine, Huddinge, Karolinska Institutet via a press release about the study.

The study comprised of almost 28,000 individuals, all all 75- and 76-year-olds in the two Swedish regions of Halland and Stockholm. The population of interest were all randomized to either screening (n=13,979) or to a control group (n=13,996), who received standard care. The screening group all completed a health questionnaire and underwent electrocardiogram.

Patients without AFib got to take home the ECG device and were asked to record their heart rhythm twice daily for two weeks. Any patients with a detected  irregular heart rhythms, the participants were referred to a cardiologist for a standardized work-up and treatment. The population were followed up for at least five years.

According to the results, the detection of AFib was higher in the screening group, and the screening group also had a slightly lower incidence of death, stroke and severe bleeding than the control group. “In total, 31.9 percent of those in the screening group experienced a negative event compared to 33 percent in the control group,” says Johan Engdahl, adjunct lecturer at the Department of Clinical Sciences, Danderyds Hospital, at Karolinska Institutet. “Now, that may sound like a small difference, but you must bear in mind that only about half of those invited to screening participated and it’s possible we would have seen a more pronounced difference had more people turned up for screening. Those who participated in the screening had significantly fewer negative events.”

 

Moreover, the results of a financial analysis yielded promising results, showing that the screening is cost-effective. “The results mean that decision-makers will be in a better position about deciding whether to move forward with recommending screening for atrial fibrillation in Sweden as well as internationally,” Dr. Svennberg says. “In future studies, we need to examine what it looks like in other health care settings in other countries and in different ethnical groups, and also if other age groups could benefit from screening.”