• Family practice · Jan 2022

    Multicenter Study

    A programme for early diagnosis of atrial fibrillation: a multi-centre study in primary care.

    • Javier D Cabrera, Guillem Fluxà, Carmen Fuentes, Jordi Hoyo, Marta Navarro, Elisenda Sant, María Amparo de la Poza, Andrés Altés, Núria Duch, Montserrat Caubet, Gerardo Vieytes, Ana M Pérez, María Alba Herrero, Pablo Gracia, Veronica Domínguez, Lluís Mont, and Blanca Coll-Vinent.
    • Atrial Fibrillation Unit, Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.
    • Fam Pract. 2022 Jan 19; 39 (1): 99-105.

    BackgroundAtrial fibrillation (AF) is a morbid disease whose complications can be prevented if prompt and correctly treated.ObjectiveTo assess the usefulness of an early AF diagnosis programme in at-risk individuals in primary care centres.MethodsIn an open-label, multi-centre, controlled interventional study, individuals with one or more risk factors for AF but without known AF were enrolled. They were allocated to intervention and control groups in a 1:2 ratio. Participants in the intervention group had three clinical and educational visits (0, 6 and 12 months). In intervention subgroup A, an electrocardiogram (ECG) was performed at each visit and in subgroup B, only if arrhythmia was detected on auscultation. After 2 years, the medical records of all participants were reviewed. Participants diagnosed with AF were followed for two additional years.ResultsOf the total 2231 participants enrolled, 1503 (67.36%) were allocated to the control group and 728 (32.63%) to the intervention groups (355 in subgroup A, 373 subgroup B). The groups showed similar clinical characteristics. New-onset AF was diagnosed in 38 patients. Early detection in subgroup B was similar to subgroup A and superior to control group (3.2% versus 1.2%, hazard ratio 3.149, 95% confidence interval 1.503-6.597, P = 0.002). AF patients in subgroups A and B had similar long-term complications and a tendency for fewer complications than AF patients in the control group.ConclusionsAn intervention programme consisting of health education, systematic auscultation and opportunistic ECG by a primary care provider is a useful method for the early diagnosis of AF.© The Author(s) 2021. Published by Oxford University Press. All rights reserved.For permissions, please e-mail: journals.permissions@oup.com.

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