Key result
An early AF diagnosis programme using health education, systematic auscultation, and opportunistic ECG was superior to control for detecting new-onset AF (3.2% vs 1.2%; HR 3.149; 95% CI 1.503-6.597; P=0.002).
Why the study?
Atrial fibrillation complications can be prevented if promptly and correctly treated, prompting the evaluation of an early AF diagnosis programme in at-risk individuals in primary care centres.
Does an early diagnosis programme involving health education, systematic auscultation, and opportunistic ECG improve the detection of atrial fibrillation in at-risk primary care patients?
RCT (n=2,231)
Open-label
1:2 ratio
Yes
Does an early diagnosis programme involving health education, systematic auscultation, and opportunistic ECG improve the detection of atrial fibrillation in at-risk primary care patients?
Hazard Ratio: 3.149 (95% CI 1.503–6.597)
Absolute Event Rate: 3.2% vs 1.2%
p-value: p=0.002
An intervention programme using systematic auscultation and opportunistic ECG in primary care significantly increases the early detection of atrial fibrillation in at-risk patients.
May increase early AF detection in primary care; hypothesis-generating pending RCTs to assess outcomes.
BACKGROUND: Atrial fibrillation (AF) is a morbid disease whose complications can be prevented if prompt and correctly treated. OBJECTIVE: To assess the usefulness of an early AF diagnosis programme in at-risk individuals in primary care centres. METHODS: In an open-label, multi-centre, controlled interventional study, individuals with one or more risk factors for AF but without known AF were enrolled. They were allocated to intervention and control groups in a 1:2 ratio. Participants in the intervention group had three clinical and educational visits (0, 6 and 12 months). In intervention subgroup A, an electrocardiogram (ECG) was performed at each visit and in subgroup B, only if arrhythmia was detected on auscultation. After 2 years, the medical records of all participants were reviewed. Participants diagnosed with AF were followed for two additional years. RESULTS: Of the total 2231 participants enrolled, 1503 (67.36%) were allocated to the control group and 728 (32.63%) to the intervention groups (355 in subgroup A, 373 subgroup B). The groups showed similar clinical characteristics. New-onset AF was diagnosed in 38 patients. Early detection in subgroup B was similar to subgroup A and superior to control group (3.2% versus 1.2%, hazard ratio 3.149, 95% confidence interval 1.503-6.597, P = 0.002). AF patients in subgroups A and B had similar long-term complications and a tendency for fewer complications than AF patients in the control group. CONCLUSIONS: An intervention programme consisting of health education, systematic auscultation and opportunistic ECG by a primary care provider is a useful method for the early diagnosis of AF.
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Cabrera et al. (2021) conducted an RCT in Atrial fibrillation risk (n=2,231). Early AF diagnosis programme (health education, systematic auscultation, and opportunistic ECG) vs. Control group was evaluated on Early detection of new-onset atrial fibrillation (HR 3.149, 95% CI 1.503-6.597, p=0.002). An early AF diagnosis programme using health education, systematic auscultation, and opportunistic ECG was superior to control for detecting new-onset AF (3.2% vs 1.2%; HR 3.149; 95% CI 1.503-6.597; P=0.002).
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