Bacchini Marco, Bonometti Samuele, Del Zotti Francesco, Lechi Alessandro, Realdon Federico, Fava Cristiano, Minuz Pietro
Federfarma Verona, Verona, Italy.
Department of Medicine, Unit of General Medicine for the Study and Treatment of Hypertensive Disease, University of Verona, Policlinico GB Rossi, Piazzale LA Scuro, 10, 37134, Verona, Italy.
High Blood Press Cardiovasc Prev. 2019 Aug;26(4):339-344. doi: 10.1007/s40292-019-00334-4. Epub 2019 Aug 5.
Opportunistic screening of atrial fibrillation is a valuable approach to the identification of subjects with unknown or non-symptomatic atrial fibrillation (AF) with the potential of reducing the burden of ischemic stroke in the population.
To evaluate the feasibility of a large-scale screening for atrial fibrillation using a blood pressure monitor (MicrolifeAFIB) endowed with a validated algorithm able to detect AF calculating the irregularity of interval times between heartbeats.
In this cross-sectional study conducted in 74 pharmacies in Verona participated 3071 people aged 50 years or more. In 6 months, information about drugs, previous diagnoses of cardiovascular diseases, anthropometric and demographic data was recorded, together with the measurement of blood pressure and cardiac rhythm by using the MicrolifeAFIB device. Pharmacists also collected anthropometric and demographic data of the participants, along with information concerning their personal history of cardiovascular disease and the use of antihypertensive and antithrombotic agents. All those who were positive at the screening for atrial fibrillation were referred to their family doctor.
The screening revealed 98 subjects (3.2%) positive for AF; 44 of these reported a previous diagnosis of AF and were treated with anticoagulants (77%) or with antiplatelet agents (7%). By logistic regression analysis, age, male sex and heart failure were independently associated with positivity for AF. Association between positive test and previous stroke/TIA was found in the 54 subjects without a previous diagnosis of AF (9% had a previous stroke/TIA).
Opportunistic screening for atrial fibrillation in the pharmacies is feasible and allows to identify a number of subjects with silent, non-previously diagnosed AF, therefore is potentially useful in large-scale projects aimed at the prevention of cardiovascular morbidity and mortality.
对心房颤动进行机会性筛查是识别不明或无症状心房颤动（AF）患者的一种有价值的方法，有可能减轻人群中缺血性中风的负担。
评估使用配备经过验证算法的血压监测仪（MicrolifeAFIB）进行大规模心房颤动筛查的可行性，该算法能够通过计算心跳间隔时间的不规则性来检测房颤。
在维罗纳的74家药店进行的这项横断面研究中，有3071名年龄在50岁及以上的人参与。在6个月内，记录了有关药物、既往心血管疾病诊断、人体测量和人口统计学数据，同时使用MicrolifeAFIB设备测量血压和心律。药剂师还收集了参与者的人体测量和人口统计学数据，以及有关他们心血管疾病个人史和使用抗高血压及抗血栓药物的信息。所有在心房颤动筛查中呈阳性的人都被转介给他们的家庭医生。
筛查发现98名受试者（3.2%）房颤呈阳性；其中44人报告既往诊断为房颤，并接受了抗凝治疗（77%）或抗血小板药物治疗（7%）。通过逻辑回归分析，年龄、男性性别和心力衰竭与房颤阳性独立相关。在54名既往未诊断为房颤的受试者中发现了阳性检测与既往中风/短暂性脑缺血发作之间的关联（9%有既往中风/短暂性脑缺血发作）。
在药店对心房颤动进行机会性筛查是可行的，并且能够识别出一些无症状、既往未诊断的房颤患者，因此在旨在预防心血管疾病发病率和死亡率的大规模项目中可能有用。
