• Emilie Katrine Kongebro, Christian Kronborg, Lucas Yixi Xing, Ketil Jørgen Haugan, Claus Graff, Søren Højberg, Morten S Olesen, Derk Krieger, Axel Brandes, Lars Køber, Jesper Hastrup Svendsen, and Søren Zöga Diederichsen.
• Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Inge Lehmanns Vej 7, 2100, Copenhagen, Denmark.
• Eur. J. Intern. Med. 2025 Jan 11.

BackgroundScreening for atrial fibrillation is rising and may worsen or improve quality of life.MethodsWe assessed quality of life (EQ-5D-5L) data in 6,004 participants with stroke risk factors randomised to usual care (n=4,503) or implantable loop recorder with anticoagulation upon detection of atrial fibrillation (n=1,501). Five domains (mobility, selfcare, usual activities, pain/discomfort, anxiety/depression) each scored from one to five were calculated into individual index scores (worst=-0.76, best=1.00). Changes in the index score and the visual analogue scale score (EQ VAS (0=worst, 100=best)) from baseline to year three were the primary outcomes, which were analysed using linear mixed models. Major problem was defined as a domain score ≥3 and analysed with logistic regression in year three.ResultsOf 6,004 participants, 5,733 (95 %) were alive after three years, and 5,162 (86 %) had complete EQ-5D-5L data. The baseline index score of 5,733 participants was 0.88 ±0.16, which decreased by -0.05 (-0.05; -0.04) in the control vs -0.04 (-0.05; -0.03) in the screening group after three years, and a baseline EQ VAS score of 78.4±16.2, which decreased by -6.06 (-6.54; -5.57) in control vs -5.18 (-5.95; -4.40) in the screening group after three years, with no significant difference between the groups (p=0.063 and p=0.056, respectively). The most frequent problem was major pain/discomfort (1,202 of 5,162 (23.3 %)), and any major problem occurred equally in the groups after three years (OR 0.91 (0.79;1.05)).ConclusionA population-based, long-term, and continuous screening for atrial fibrillation in high-risk individuals did not translate into increased quality of life.Copyright © 2025 The Author(s). Published by Elsevier B.V. All rights reserved.

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