A programme for early diagnosis of atrial fibrillation: a multi-centre study in primary care. (23rd June 2021)

• Record Type: Journal Article
• Authors: Cabrera, Javier D; Fluxà, Guillem; Fuentes, Carmen; Hoyo, Jordi; Navarro, Marta; Sant, Elisenda; de la Poza, María Amparo; Altés, Andrés; Duch, Núria; Caubet, Montserrat; Vieytes, Gerardo; Pérez, Ana M; Herrero, María Alba; Gracia, Pablo; Domínguez, Veronica; Mont, Lluís; Coll-Vinent, Blanca
• Is Part Of: Family practice. Volume 39:Number 1(2022)
• Page Start: 99
• Page End: 105
• Publication Date: 2021-06-23
• Subjects: Atrial fibrillation -- auscultation -- early diagnosis -- education -- prevention -- primary care; Primary care (Medicine) -- Periodicals; Clinical medicine -- Periodicals; 616.005
• DOI: 10.1093/fampra/cmab057
• Languages: English
• ISSNs: 0263-2136

Abstract

Abstract: Background: Atrial fibrillation (AF) is a morbid disease whose complications can be prevented if prompt and correctly treated. Objective: To assess the usefulness of an early AF diagnosis programme in at-risk individuals in primary care centres. Methods: In an open-label, multi-centre, controlled interventional study, individuals with one or more risk factors for AF but without known AF were enrolled. They were allocated to intervention and control groups in a 1:2 ratio. Participants in the intervention group had three clinical and educational visits (0, 6 and 12 months). In intervention subgroup A, an electrocardiogram (ECG) was performed at each visit and in subgroup B, only if arrhythmia was detected on auscultation. After 2 years, the medical records of all participants were reviewed. Participants diagnosed with AF were followed for two additional years. Results: Of the total 2231 participants enrolled, 1503 (67.36%) were allocated to the control group and 728 (32.63%) to the intervention groups (355 in subgroup A, 373 subgroup B). The groups showed similar clinical characteristics. New-onset AF was diagnosed in 38 patients. Early detection in subgroup B was similar to subgroup A and superior to control group (3.2% versus 1.2%, hazard ratio 3.149, 95% confidence interval 1.503–6.597, P = 0.002). AF patients in subgroups A and B had similar long-term complications and a tendency for fewer complications than AF patients in the control group. Conclusions: An intervention programme consisting of health education, systematic auscultation and opportunistic ECG by a primary care provider is a useful method for the early diagnosis of AF.