Opportunistic and systematic screening for atrial fibrillation in adults aged ≥ 65 years in primary care: a systematic review of randomized and cluster randomized trials.
Mohamed Ali Mansour, Mohamed Ezzat Ibrahim Hussein, Mohamed Shawky Al-Didamony Tantawy Foda
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In 30 seconds
This systematic review evaluated the effectiveness of opportunistic versus systematic atrial fibrillation (AF) screening in adults aged ≥ 65 years. Nine randomized trials were analyzed, revealing that both screening methods improved AF detection compared to usual care. However, no consistent reduction in stroke incidence or all-cause mortality was observed across studies.
Key findings
- Both opportunistic and systematic screening increased AF detection compared to usual care.
- Prolonged or continuous monitoring generally yielded higher AF detection rates.
- No consistent reduction in stroke incidence or all-cause mortality was observed across studies.
- Most trials had concerns regarding risk of bias, particularly due to pragmatic designs.
Why it matters
Understanding the effectiveness of AF screening methods is crucial for improving early detection in older adults, potentially leading to better management and outcomes. However, the lack of consistent clinical outcome improvements suggests a need for further research.
What to keep in mind
The included studies exhibited substantial clinical and methodological heterogeneity, and most trials had concerns regarding risk of bias.