Quarterly versus annual ECG screening for atrial fibrillation in older Chinese individuals (AF-CATCH): a prospective, randomised controlled trial

Abstract

Background Screening for atrial fibrillation before onset of symptoms and the subsequent initiation of oral anticoagulants could prevent stroke and death. The most cost-effective strategy to screen for atrial fibrillation in a population at high risk aged 65 years and older is unknown. Therefore, we aimed to investigate whether more frequent electrocardiography (ECG) recordings would significantly improve the detection of atrial fibrillation compared with annual ECG screenings. MethodsWe did a randomised controlled trial that compared different screening frequencies of 30 s single-lead ECG (AliveCor Heart Monitor) in the detection of atrial fibrillation in Chinese residents (≥65 years) in five community health centres in Shanghai, China. Only participants without history of atrial fibrillation and without atrial fibrillation rhythm at baseline were eligible for inclusion in the trial. Random assignment was done with the use of a random number table and stratified for study site. Participants were randomly assigned in a 1:1 ratio to annual or quarterly screening groups. The quarterly screening group was further randomly assigned in a 3:1 ratio to subgroups of quarterly screening and quarterly screening plus (which involved ECG screening once per week for the first month of follow-up, then quarterly for the remainder of follow-up). The primary outcome was the detection rate of atrial fibrillation. The intention-to-treat analysis was done for all randomly assigned patients who had at least one ECG recording during follow-up. This trial was registered at ClinicalTrials.gov, NCT02990741, and terminated on Oct 31, 2020.

Electrocardiogram prediction of atrial fibrillation risk after stroke: A protocol for systematic review and meta-analysis

“…[ 46 , 47 ] In China, the prevalence of AF in the population over 35 years old is 0.74% for males and 0.72% for females, with a significant increase in prevalence with age. [ 48 ] AF increases the risk of stroke and systemic embolism by 5 times and the risk of heart failure by 3 times. AF patients have significantly higher mortality, disability, and recurrence rates compared to other types of strokes, nearly double the rates.…”

Accuracy of the OMRON HEM-7361T blood pressure monitor in the differentiation between atrial fibrillation and sinus rhythm

“…Although it is sufficiently accurate and has been used in previous atrial fibrillation screen studies [10,11], it may still misclassify some of the cardiac rhythms. Third, our study focused on the accuracy of atrial fibrillation detection but not BP measurement.…”

Detektion von Vorhofflimmern mit Wearables

“…Die Häufigkeit der EKG-Messung ist Gegenstand einer anhaltenden Debatte und bewegt sich meist zwischen kontinuierlicher bis zu jährlicher Messung. Zhan et al konnte in der AF-CATCH-Studie zeigen, dass eine vierteljährliche EKG-Messung mit einer deutlich höheren Detektionsrate gegenüber einer jährlichen Messung überlegen war [19]. Wohingegen eine wöchentliche Messung keine relevante Steigerung der Prädiktion in einer Risikokohorte von über 65-Jährigen erreichte.…”