Are We Ready for Mass Screening to Detect Atrial Fibrillation?

Atrial fibrillation (AF) is the most common cardiac arrhythmia1 and a leading cause of stroke.2 AF-related strokes are associated with significant morbidity, mortality, and healthcare costs,2–5 yet they are highly preventable.6,7 Unfortunately, AF is often undiagnosed or untreated when stroke occurs.8 Given the availability of effective oral anticoagulant (OAC) medications and evidence-based guidelines for their use,9–11 population-based AF screening has the potential to become an important public health program.Article see p 2176There is considerable interest in developing AF screening programs for 3 reasons: (1) The prevalence of AF is increasing as a result of our aging population; (2) new OAC medications offer safe, effective, and convenient therapy for patients once AF is identified; and (3) a variety of portable, wearable, and implantable technologies have been developed to detect AF, which may facilitate AF screening in a variety of clinical settings.12–14 Although there is great optimism for AF screening, high-quality studies examining optimal AF screening methods, settings, and target populations are only starting to emerge.12,13,15In this issue of Circulation , Svennberg and colleagues16 report the results of the STROKESTOP study, a prospective, population-based study of systematic AF screening with intermittent ambulatory …