Atrial Fibrillation Screening: Burden or Benefit for Patients and the Healthcare System

Atrial fibrillation (AF) is the most common sustained arrhythmia and raises ischemic stroke risk fivefold, even when asymptomatic. Early detection and timely initiation of oral anticoagulation can significantly reduce stroke incidence, motivating interest in population-level AF screening. This review synthesizes findings from large-scale trials and digital health studies, including wearable device-based detection, and highlights both benefits and limitations of screening. Benefits include earlier diagnosis of silent AF, timely treatment, and potential reductions in stroke burden. However, drawbacks such as false positives, inconclusive results, unnecessary follow-up testing, patient anxiety, and resource strain remain important concerns. Emerging strategies-such as AI-guided risk stratification, improved signal processing, and integrated digital care pathways-offer promise in improving diagnostic accuracy, reducing false alarms, and streamlining clinical management. When implemented through targeted, technology-enhanced approaches, AF screening has the potential to benefit patients and healthcare systems by preventing strokes and optimizing resource use. However, its overall value depends on balancing improved detection and clinical outcomes against the risks of overdiagnosis, psychological burden, and system costs. Ultimately, the success of AF screening will require careful integration of novel technologies with evidence-based care pathways to ensure clinically meaningful and sustainable healthcare impact.