Screening for atrial fibrillation offers a small net benefit in an older population, according to a study published online in The Lancet.
Emma Svennberg, PhD, from the Karolinska Institutet in Stockholm, and colleagues conducted a multicenter randomized controlled trial involving 75- to 76-year-olds from Halland and Stockholm in Sweden. Participants were randomly assigned to be invited to screening for atrial fibrillation or to a control group (14,387 and 14,381, respectively). Participants were asked to register for intermittent electrocardiograms (ECGs) for 14 days; if atrial fibrillation was detected or untreated, treatment with oral anticoagulants was offered.
Of those invited to screening, 7,165 (51.3 percent) of 13,979 participated. The researchers found that significantly fewer primary end point events (ischemic or hemorrhagic stroke, systemic embolism, bleeding leading to hospitalization, or all-cause death) occurred in the intervention group versus the control group after a median follow-up of 6.9 years (5.45 versus 5.68 events per 100 years; hazard ratio, 0.96; 95 percent confidence interval, 0.92 to 1.00; P = 0.045).
“Screening for atrial fibrillation in an older population showed a significant benefit by reducing hard clinical outcomes,” the authors write. “Screening for atrial fibrillation is likely to show a greater difference in outcomes in populations with lower spontaneous detection of atrial fibrillation, as well as in settings with higher participation rates.”
Several authors disclosed financial ties to pharmaceutical companies, including Boehringer Ingelheim, Bayer, and Bristol Myers Squibb-Pfizer, which partially funded the study.