Key result
This study protocol outlines a planned implementation study to evaluate opportunistic atrial fibrillation screening using a handheld ECG device in up to 4,000 primary care patients aged ≥65 years.
Why the study?
Although AF screening is recommended to prevent stroke, there are multiple screening modalities; this study investigates the acceptability, feasibility, and impact of primary care screening using a handheld mobile ECG device.
Is opportunistic screening for atrial fibrillation using a handheld mobile ECG device acceptable, feasible, and impactful in primary care patients aged ≥65 years?
Is opportunistic screening for atrial fibrillation using a handheld mobile ECG device acceptable, feasible, and impactful in primary care patients aged ≥65 years?
This protocol outlines a mixed-methods evaluation of an opportunistic atrial fibrillation screening program using a handheld ECG device in Irish primary care.
Protocol for handheld ECG AF screening in primary care patients ≥65 may inform implementation; leaves open real-world yield, cost, and outcomes.
INTRODUCTION: Atrial fibrillation (AF) is a major risk factor for stroke. There is a fivefold increase in stroke risk in the presence of AF. The irregular beating of the heart enables blood stasis which allows clots to form. These can migrate to the brain causing a stroke. AF is common and its incidence increases with age. AF is often asymptomatic and early detection enables effective preventive treatment reducing stroke risk by up to two-thirds.Stroke contributes significantly to morbidity and mortality globally. In Ireland, it is the leading cause of acquired disability and second leading cause of death. The cost associated with stroke is significant. Stroke risk increases with age and is a public health priority.Internationally, there is consensus among experts that AF screening is valuable. In Ireland, the National Cardiovascular Policy recommended establishing a screening programme. However, there are many ways to screen for AF including pulse palpation, mobile ECG devices, 12-lead ECG and personal health monitoring devices.This study aims to investigate the acceptability, feasibility and impact of AF screening in primary care using a handheld mobile ECG device. METHODS AND ANALYSIS: General practitioners (GPs) and practice nurses in the South of Ireland will opportunistically screen patients aged ≥65 years for AF at routine consultation using a handheld one-lead ECG device, KardiaMobile. This study will screen up to 4000 patients. Blood pressure and smoking status will be checked concurrently. A mixed-method evaluation will be undertaken including a partial economic evaluation. Anonymised data will be collected from participating practices and qualitative interviews will be conducted with GP, nurse and patient participants. ETHICS AND DISSEMINATION: Ethical approval has been granted by the Clinical Research Ethics Committee in University College Cork. Dissemination will involve publication in peer-reviewed journals and presentation at national and international conferences.
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Callanan et al. (2022) studied Atrial fibrillation (n=4,000). Opportunistic AF screening using a handheld one-lead ECG device (KardiaMobile) was evaluated on Acceptability, feasibility and impact of AF screening. This study protocol outlines a planned implementation study to evaluate opportunistic atrial fibrillation screening using a handheld ECG device in up to 4,000 primary care patients aged ≥65 years.
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