Insights on Comprehensive Management of Atrial Fibrillation
Insights on Comprehensive Management of Atrial Fibrillation
Many patients have AF and it is frequently asymptomatic. The panel made an important call that "…the detection and thromboprophylaxis of AF should be a UK NHS priority for the prevention of disabling cardioembolic stroke, with all of its consequences for individuals and for health and social care resources" Also, screening for AF in people aged 65 years or older satisfies the UK National Screening Committee criteria for a screening program, and thus, such a national screening program should be initiated in the UK.
The most cost-effective method for the detection of AF in primary care is by opportunistic screening of people aged ≥65 years by pulse palpation, and if an irregular pulse is found, the arrhythmia should be confirmed with an ECG. Where paroxysmal AF is suspected, including after ischemic stroke or transient ischemic attack, longer ECG monitoring periods (at least 24 h) or event recorders should be used. This is pertinent given that only one in 12 paroxysms of AF are symptomatic. Also, if one looks hard enough, AF can be found in one in 20 patients presenting with an acute ischemic stroke.
How Can We Best Detect AF?
Many patients have AF and it is frequently asymptomatic. The panel made an important call that "…the detection and thromboprophylaxis of AF should be a UK NHS priority for the prevention of disabling cardioembolic stroke, with all of its consequences for individuals and for health and social care resources" Also, screening for AF in people aged 65 years or older satisfies the UK National Screening Committee criteria for a screening program, and thus, such a national screening program should be initiated in the UK.
The most cost-effective method for the detection of AF in primary care is by opportunistic screening of people aged ≥65 years by pulse palpation, and if an irregular pulse is found, the arrhythmia should be confirmed with an ECG. Where paroxysmal AF is suspected, including after ischemic stroke or transient ischemic attack, longer ECG monitoring periods (at least 24 h) or event recorders should be used. This is pertinent given that only one in 12 paroxysms of AF are symptomatic. Also, if one looks hard enough, AF can be found in one in 20 patients presenting with an acute ischemic stroke.
Source...