Roumegou Pierre, Degand Bruno, Le Gal François, Garcia Rodrigue
Unité de rythmologie, centre cardio-vasculaire, CHU de Poitiers, Poitiers, France.
Rev Prat. 2020 Oct;70(8):899-902.
Screening and diagnosis of atrial fibrillation. Screening for atrial fibrillation (AF) is crucial as this arrhythmia is asymptomatic in a third of patients and 5% of patients present a stroke as the first manifestation of their AF. The European Society of Cardiology recommends opportunistic screening of AF in patients over 65 years of age and systematically in patients over 75 years of age. The simplest way is pulse taking, but the number of connected devices for AF screening allows to multiply the frequency of screening and thus increase sensitivity, with another advantage of a digitalized transmission of the tracing. However many questions remain. No scientific evidence has demonstrated a benefit for AF screening. We do not know what duration and frequency of screening is relevant. The burden of AF which increases thromboembolic risk is not known. What population should be screened and how to consider subclinical AF? We will obtain answers to our questions in the coming years thanks to the results of the various studies in progress.
心房颤动的筛查与诊断。心房颤动(AF)的筛查至关重要,因为这种心律失常在三分之一的患者中无症状,且5%的患者以中风作为其房颤的首发表现。欧洲心脏病学会建议对65岁以上患者进行房颤机会性筛查,对75岁以上患者进行系统性筛查。最简单的方法是触诊脉搏,但用于房颤筛查的联网设备数量增多,使得筛查频率得以增加,从而提高了敏感性,还有一个优点是心电图可数字化传输。然而,仍有许多问题存在。尚无科学证据表明房颤筛查有益。我们不知道何种筛查时长和频率是合适的。增加血栓栓塞风险的房颤负担尚不清楚。应该对哪些人群进行筛查以及如何看待亚临床房颤?得益于正在进行的各项研究结果,我们将在未来几年得到这些问题的答案。