Log in with your email address username.

×

Important notice

doctorportal Learning is on the move as we will be launching a new website very shortly. If you would like to sign up to dp Learning now to register for CPD learning or to use our CPD tracker, please email support@doctorportal.com.au so we can assist you. If you are already signed up to doctorportal Learning, your login will work in the new site so you can continue to enrol for learning, complete an online module, or access your CPD tracker report.

To access and/or sign up for other resources such as Jobs Board, Bookshop or InSight+, please go to www.mja.com.au, or click the relevant menu item and you will be redirected.

All other doctorportal services, such as Find A Doctor, are no longer available.

Atrial fibrillation screening back in the picture

Atrial fibrillation screening back in the picture - Featured Image

Population screening for atrial fibrillation is once more up for discussion as a new study shows that people with newly diagnosed ‘silent’ AF actually have a higher risk of stroke than those with a symptomatic condition.

The study, presented this week at the European Heart Rhythm Association meeting in Vienna, included over 6,000 consecutively enrolled patients with non-valvular atrial fibrillation, of whom around two-thirds were asymptomatic or minimally symptomatic at time of diagnosis.

The study found those with asymptomatic AF had more than double the risk of previous stroke, compared to those who were symptomatic (14.7% vs 6.0%). They were also more likely to have permanent atrial fibrillation than those in the symptomatic group (15.8% vs 8.3%).

But both symptomatic and asymptomatic patients in this study had a similar number of stroke risk factors, with an average CHA2DS2-VASc score of 3.3 for each group.

Lead author Dr Steffen Christow, a cardiologist at Hospital Ingolstadt in Germany, said the higher rate of stroke despite the same number of stroke risk factors may be explained by a longer undiagnosed history of AF in those with asymptomatic disease.

“Our study found that in Western Europe, two-thirds of patients newly diagnosed with atrial fibrillation were asymptomatic. Without detection, patients may not receive appropriate preventive therapy and remain at increased risk of stroke.”

He said the results “underline the urgent need for public programs to detect atrial fibrillation in the general population”.

In Australia, RACGP guidelines do not recommend systematic screening for atrial fibrillation, although they say opportunistic screening when taking blood pressure could be cost-effective.

The current study is a sub-analysis of the GLORIA-AF registry, which characterises a population of newly diagnosed patients with non-valvular atrial fibrillation at risk for stroke, studying patterns, predictors and outcomes of different treatment regimens for stroke prevention.

You can access the study abstract here.

email