Key result
Community-based 30-second ECG screening in 23,572 adults detected AF in 1.19% of participants and significantly increased OAC prescription rates (e.g., 11.4% to 60.6% in Chiayi county, P<0.001).
Why the study?
Community-based AF screening programs incorporated into government-endorsed health care systems are rarely reported in Asian countries.
Does adding single-lead 30-second ECG recording to adult health check programs improve AF detection and OAC prescription rates in community-dwelling adults?
Cross-Sectional (n=23,572)
Yes
Does adding single-lead 30-second ECG recording to adult health check programs improve AF detection and OAC prescription rates in community-dwelling adults?
p-value: p=<0.001
Incorporating a 30-second single-lead ECG into government-endorsed adult health check programs is feasible and significantly increases the detection of AF and subsequent oral anticoagulant prescription rates.
Supports community ECG screening feasibility for AF; leaves open outcome benefits in observational programs.
Background Although international guidelines recommended opportunistic screening for atrial fibrillation (AF), the community-based AF screening program incorporated into the government-endorsed health care system is rarely reported in Asian countries. Objectives We aimed to test the feasibility of adding AF screening into the preexistent adult health check program and report the AF detection rate and percentages of OAC prescriptions before and after AF screening with the involvement of public health care systems. Methods We performed this program in three counties (Chiayi county, Keelung City, and Yilan county) in Taiwan which have their own official preexistent adult health check programs conducted by public health bureaus for years. However, electrocardiography (ECG) was not included in these programs before. We cooperated with the public health bureaus of the three counties and performed single-lead 30-second ECG recording for every participant. Results From January to December 2020, AF screening was performed in 199 sessions with 23,572 participants. AF was detected in 278 subjects with a detection rate of 1.19% (age ≥65 years: 2.39%; ≥75 years: 3.73%). The mean CHA2DS2-VASc score of these 278 subjects was 2.36, with 91% of them had a score ≥1 (males) or ≥2 (females). The number needed to screen was 42 and 27 for subjects aged ≥65 and ≥75 years, respectively. The prescription rate of OACs significantly increased from 11.4 to 60.6% in Chiayi county and from 15.8 to 50.0% in Keelung City after screening (both p-values <0.001). Conclusion This community-based and government-endorsed AF screening project in Taiwan demonstrated that incorporation of AF screening into the preexistent adult health check programs through co-operations with the government was feasible. Actions to detect AF, good education, and well-organized transferring plan after AF being detected with the involvement of public health care systems could result in a substantial increase in the prescription rate of OACs.
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Chao et al. (2023) conducted a cross-sectional in Atrial Fibrillation (n=23,572). Community-based single-lead 30-second ECG screening vs. Pre-screening (historical) was evaluated on AF detection rate and OAC prescription rate (p=<0.001). Community-based 30-second ECG screening in 23,572 adults detected AF in 1.19% of participants and significantly increased OAC prescription rates (e.g., 11.4% to 60.6% in Chiayi county, P<0.001).
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