Modesti Pietro Amedeo, Donigaglia Gianni, Fabiani Plinio, Mumoli Nicola, Colella Andrea, Boddi Maria
Dipartimento di Medicina Sperimentale e Clinica, Universita' degli Studi di Firenze, Largo Brambilla 3, 50134, Florence, Italy.
Direttore di Zona Distretto Elba, ATNO, Portoferraio, Livorno, Italy.
Intern Emerg Med. 2017 Dec;12(8):1081-1086. doi: 10.1007/s11739-017-1752-3. Epub 2017 Sep 19.
Early identification of atrial fibrillation (AF) is now a priority in cardiovascular prevention because AF is common although often asymptomatic, and is associated with poor outcomes that are highly preventable with appropriate medical treatment. In Italy, AF prevalence among subjects aged ≥65 years ranges from 5 to 6% in observational studies based on the diagnosis recorded by general practitioners to 10-11% in studies where ECG screening is routinely offered. It is thus evident that a large number of subjects are not detected by conventional approach, and new strategies are required to increase early detection of AF. In particular, the changing position of pharmacies in the health system should be considered. Because of its small geographical size, insular nature and captive population, the Isle of Elba represents an ideal setting to test new strategies for stroke reduction. The Elba-FA project was thus designed to determine the feasibility and impact of the combined involvement of pharmacies and general practices to screen undiagnosed AF, with the ultimate aim of reducing the burden of stroke and arterial thromboembolism. The findings obtained with this approach might have broad implications for cardiovascular prevention at the general population level in Italy.
心房颤动（AF）的早期识别现已成为心血管疾病预防的重点，因为AF很常见，尽管通常无症状，且与不良预后相关，而适当的药物治疗可有效预防这些不良后果。在意大利，基于全科医生记录的诊断，≥65岁人群中AF的患病率在观察性研究中为5%至6%，而在常规进行心电图筛查的研究中为10%至11%。因此，很明显，传统方法无法检测出大量AF患者，需要新的策略来提高AF的早期检测率。特别是，应考虑药房在卫生系统中角色的转变。由于厄尔巴岛面积小、呈岛屿状且人口固定，因此是测试降低中风新策略的理想场所。因此，厄尔巴岛房颤项目旨在确定药房和全科医疗联合参与筛查未诊断出的AF的可行性和影响，最终目标是减轻中风和动脉血栓栓塞的负担。通过这种方法获得的结果可能对意大利普通人群层面的心血管疾病预防具有广泛影响。
