Atrial Fibrillation Screening in High-Risk Patients Using a Single Lead ECG Device: A Tertiary Hospital Experience

Background Atrial Fibrillation (AF) is a major public health problem and one of the commonest supraventricular arrhythmias. At least 20% of all strokes are directly attributable to AF. However, its burden is not clear in sub-Saharan Africa, possibly due in part to undervaluation and non-recognition. In recent decades several new devices have been developed for the betterment of the accuracy and rates of AF detection, which also offers flexibility and feasibility. Objective The objective of the study is to identify the prevalence of known and Unknown AF in a high-risk patient population using a validated single-lead ECG. Methods and materials An institution-based cross-sectional study was conducted in 410 adults (≥55 years) recruited from Tikur Anbessa hospital sub-specialty outpatient clinics from July to October 2021. ECG tracing was conducted using (AliveCor) SL ECG device. A standardized questionnaire was designed to collect socio-demographic and clinical information using ODK Collect v2021. 3.0. we used logistic regression to determine the potential associated factors. Results The overall prevalence of AF in our study was 4.8%. It was strongly associated with age, diagnosis of heart failure, Substance use and high monthly income according to World Bank (WB) category. All the newly diagnosed patients were not on anticoagulation for stroke prevention. Conclusion and Recommendations Single timepoint screening in high-risk patients identified previously unknown AF in 2.1 %, out of which the majority were eligible for anticoagulation therapy. Identification of AF through targeted screening with up incoming novel technologies could reduce the stroke burden associated with undiagnosed AF.