Luisa Benito1, Blanca Coll-Vinent2, Eva Gómez1, David Martí1, Joan Mitjavila1, Ferran Torres1, Òscar Miró2, Antoni Sisó1, Lluís Mont3. 1. Unitat de Fibril·lació Auricular (UFA), Hospital Clínic, Universitat de Barcelona, Villarroel 170, Barcelona, Catalonia 08036, Spain CAPSBE Les Corts Barcelona, Catalonia, Spain. 2. Unitat de Fibril·lació Auricular (UFA), Hospital Clínic, Universitat de Barcelona, Villarroel 170, Barcelona, Catalonia 08036, Spain Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain. 3. Unitat de Fibril·lació Auricular (UFA), Hospital Clínic, Universitat de Barcelona, Villarroel 170, Barcelona, Catalonia 08036, Spain Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain lmont@clinic.cat.
Abstract
AIM: Atrial fibrillation (AF) is associated with high morbidity and mortality. Early diagnosis is likely to improve therapy and prognosis. The study objective was to evaluate the usefulness of a programme for early diagnosis of AF in patients from an urban primary care centre. METHODS AND RESULTS:Participants were recruited from a randomized sample of patients not diagnosed with AF but having relevant risk factors: age ≥ 65 years, ischaemic and/or valvular heart disease, congestive heart failure, hypertension, and/or diabetes. Patients were randomly assigned to the intervention group (IG) or control group (CG). The intervention included (i) initial visit with clinical history, electrocardiogram, and instruction about pulse palpation and warning signs and (ii) electrocardiogram every 6 months during a 2-year follow-up. The main endpoint of the study was the proportion of new cases diagnosed at 6 months. Secondary endpoints were number of new AF diagnoses and complications associated with the arrhythmia in both groups. A total of 928 patients were included (463 IG and 465 CG). At 6 months, AF was diagnosed in 8 IG patients and 1 CG patient (1.7 vs. 0.2%, respectively, P = 0.018). After 2 years of follow-up, 11 IG patients and 6 CG patients had newly diagnosed AF (2.5 vs. 1.3%, respectively, P = 0.132). Time to first diagnosis of AF was shorter in IG patients [median (inter-quartile range): 7 (192) days vs. 227 (188.5) days in CG, P = 0.029]. CONCLUSION: The simple screening proposed could be useful for the early detection of AF in primary care. Published on behalf of the European Society of Cardiology. All rights reserved.
RCT Entities:
AIM: Atrial fibrillation (AF) is associated with high morbidity and mortality. Early diagnosis is likely to improve therapy and prognosis. The study objective was to evaluate the usefulness of a programme for early diagnosis of AF in patients from an urban primary care centre. METHODS AND RESULTS:Participants were recruited from a randomized sample of patients not diagnosed with AF but having relevant risk factors: age ≥ 65 years, ischaemic and/or valvular heart disease, congestive heart failure, hypertension, and/or diabetes. Patients were randomly assigned to the intervention group (IG) or control group (CG). The intervention included (i) initial visit with clinical history, electrocardiogram, and instruction about pulse palpation and warning signs and (ii) electrocardiogram every 6 months during a 2-year follow-up. The main endpoint of the study was the proportion of new cases diagnosed at 6 months. Secondary endpoints were number of new AF diagnoses and complications associated with the arrhythmia in both groups. A total of 928 patients were included (463 IG and 465 CG). At 6 months, AF was diagnosed in 8 IG patients and 1 CG patient (1.7 vs. 0.2%, respectively, P = 0.018). After 2 years of follow-up, 11 IG patients and 6 CG patients had newly diagnosed AF (2.5 vs. 1.3%, respectively, P = 0.132). Time to first diagnosis of AF was shorter in IG patients [median (inter-quartile range): 7 (192) days vs. 227 (188.5) days in CG, P = 0.029]. CONCLUSION: The simple screening proposed could be useful for the early detection of AF in primary care. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Pawel Petryszyn; Piotr Niewinski; Aleksandra Staniak; Patryk Piotrowski; Anna Well; Michal Well; Izabela Jeskowiak; Gregory Lip; Piotr Ponikowski Journal: PLoS One Date: 2019-03-20 Impact factor: 3.240