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Atrial fibrillation screening should be routine - GPs

Tuesday April 5th 2022

GPs believe atrial fibrillation screening could be integrated into flu vaccination and cancer screening programmes, according to a new Europe study.

A study of GPs by the AFFECT-EU project, a large-scale EU funded project, has sought to define the optimal screening strategy for atrial fibrillation. This was presented at the European Society of Cardiology EHRA 2022, in Copenhagen, Denmark, yesterday.

Study author Ms. Paulien Vermunicht, a doctoral student at the University of Antwerp, Belgium, said: “Our study indicates that few atrial fibrillation screening programmes are established in Europe, yet GPs strongly believe they are needed.”

AFFECT-EU has previously reported that opportunistic screening in primary care with single lead electrocardiogram (ECG) devices was the most feasible approach by healthcare professionals and regulators.

For this study, GPs in Europe were asked their opinions of implementing this screening approach in daily clinical practice.

A multiple choice survey was emailed to GP contacts of AFFECT-EU consortium members and GP organisations and there were 561 responses (37.1% Eastern, 29.4% Central, 12.1% Southern, 11.1% Northern, 9.4% Western Europe and 0.9% outside Europe).

When it came to screening, 87% of GPs said there was no atrial fibrillation screening established in their region, while 70.1%, 80.9% and 87.3% said programmes were in place for colon, breast and cervical cancers, respectively.

However, the need for standardised atrial fibrillation screening was rated as 82.3 on a scale from 0 to 100, which was almost as high as for colon (86.5), breast (86.8) and cervical (89.2) cancers.

Out of the respondents, 12.8% of GPs had a single lead ECG device in their practice, but three in five (60.4%) said they would feel confident in ruling out atrial fibrillation on a 30-second single lead ECG rhythm strip.

While one in four (25.3%) GPs reported no obstacles to starting atrial fibrillation screening, almost one in five (18.9%) said they needed more education before starting.

Almost one in five (18.7%) reported there were insufficient resources to implement a programme in their practice, while just over one in ten (10.5%) were concerned about detecting false positives that could lead to anxiety or harm for the patient.

One of the main solutions, selected by 24.3% of GPs, was to integrate atrial fibrillation screening into existing flu vaccination or cancer screening programmes.

The second most popular idea, selected by 24.2% of respondents, was to incorporate an algorithm into primary care software systems to identify patients suitable for atrial fibrillation screening based on their age and/or medical history.

Project coordinator Professor Renate Schnabel, of the University Medical Centre Hamburg-Eppendorf, Germany said: “The AFFECT-EU consortium has created an algorithm that identifies patients at risk of atrial fibrillation based on the information in their medical record.

“When the patient visits the practice for any reason, the primary care software system alerts GPs who can then perform ECG screening. This procedure is being tested in Germany and is a big step forward.”

Tags: Europe | Heart Health

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