Key result
Ambulatory ECG screening detects incidental non-AF arrhythmias in 4-96% of patients depending on reporting definitions.
Why the study?
Ambulatory ECG monitoring frequently identifies incidental arrhythmias, but their prevalence during community-based AF screening remains uncertain.
What is the prevalence of incidental non-AF arrhythmias during continuous ambulatory ECG screening in community-based populations?
Meta-Analysis (n=136,344)
What is the prevalence of incidental non-AF arrhythmias during continuous ambulatory ECG screening in community-based populations?
Incidental non-AF findings during continuous ambulatory ECG screening in AF-free cohorts vary widely in prevalence, highlighting the need for uniform reporting and further research into their clinical relevance.
Wide variability in non-AF incidental findings during AF screening cautions against overinterpretation; leaves open standardization needs and clinical relevance.
Ambulatory ECG monitoring frequently identifies incidental arrhythmias, but their prevalence in community-based atrial fibrillation (AF) screening remains uncertain. For this systematic review, we searched PubMed, Embase, Cochrane, and CINAHL through January 2025 for studies on ECG abnormalities in community-based screening. Eligible studies included randomized trials or observational cohorts without prior AF that used ≥ 24-hour continuous rhythm monitoring and reported at least one incidental non-AF finding. We included 25 publications (17 cohorts, 136,344 participants; mean age 41-80, 0-100% female). Non-AF abnormalities occurred in 4-96%, including supraventricular and ventricular arrhythmias and conduction defects. Meta-analyses demonstrated substantial heterogeneity in the reported prevalences of most potentially serious incidental findings, as well as other non-AF abnormalities. Sustained ventricular tachycardias were the only exception, showing low heterogeneity (I² 0.00%) and low pooled prevalence (0.2%). Overall, the prevalence of non-AF incidental findings during continuous ambulatory ECG screening in AF-free primary care and community-based cohorts varied widely, largely reflecting differences in definitions and reporting practices. This highlights the need for uniform reporting and further research into the prevalence and clinical relevance of these findings.
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Brik et al. (2026) conducted a meta-analysis in Atrial fibrillation screening (AF-free) (n=136,344). ≥ 24-hour continuous ambulatory ECG monitoring was evaluated on Prevalence of incidental non-AF findings. Continuous ambulatory ECG screening in AF-free community cohorts identified non-AF abnormalities in 4-96% of participants, with sustained ventricular tachycardias having a pooled prevalence of 0.2%.
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