Vermunicht Paulien, Grecu Mihaela, Deharo Jean-Claude, Buckley Claire M, Palà Elena, Mairesse Georges H, Farkowski Michal M, Bergonti Marco, Pürerfellner Helmut, Hanson Coral L, Neubeck Lis, Freedman Ben, Witt Henning, Hills Mellanie T, Lund Jenny, Giskes Katrina, Engler Daniel, Schnabel Renate B, Heidbuchel Hein, Desteghe Lien
Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium.
Research Group Cardiovascular Diseases, University of Antwerp, Antwerp, Belgium.
Front Cardiovasc Med. 2023 Feb 15;10:1112561. doi: 10.3389/fcvm.2023.1112561. eCollection 2023.
There is no clear guidance on how to implement opportunistic atrial fibrillation (AF) screening in daily clinical practice.
This study evaluated the perception of general practitioners (GPs) about value and practicalities of implementing screening for AF, focusing on opportunistic single-time point screening with a single-lead electrocardiogram (ECG) device.
A descriptive cross-sectional study was conducted with a survey developed to assess overall perception concerning AF screening, feasibility of opportunistic single-lead ECG screening and implementation requirements and barriers.
A total of 659 responses were collected (36.1% Eastern, 33.4% Western, 12.1% Southern, 10.0% Northern Europe, 8.3% United Kingdom & Ireland). The perceived need for standardized AF screening was rated as 82.7 on a scale from 0 to 100. The vast majority (88.0%) indicated no AF screening program is established in their region. Three out of four GPs (72.1%, lowest in Eastern and Southern Europe) were equipped with a 12-lead ECG, while a single-lead ECG was less common (10.8%, highest in United Kingdom & Ireland). Three in five GPs (59.3%) feel confident ruling out AF on a single-lead ECG strip. Assistance through more education (28.7%) and a tele-healthcare service offering advice on ambiguous tracings (25.2%) would be helpful. Preferred strategies to overcome barriers like insufficient (qualified) staff, included integrating AF screening with other healthcare programs (24.9%) and algorithms to identify patients most suitable for AF screening (24.3%).
GPs perceive a strong need for a standardized AF screening approach. Additional resources may be required to have it widely adopted into clinical practice.
在日常临床实践中，对于如何实施机会性房颤（AF）筛查尚无明确指导。
本研究评估全科医生（GPs）对实施AF筛查的价值和实用性的看法，重点是使用单导联心电图（ECG）设备进行机会性单次筛查。
开展了一项描述性横断面研究，通过一项调查来评估对AF筛查的总体看法、机会性单导联ECG筛查的可行性以及实施要求和障碍。
共收集到659份回复（东欧占36.1%，西欧占33.4%，南欧占12.1%，北欧占10.0%，英国和爱尔兰占8.3%）。在0至100的评分中，对标准化AF筛查的感知需求评分为82.7。绝大多数（88.0%）表示其所在地区未建立AF筛查项目。四分之三的全科医生（72.1%，在东欧和南欧比例最低）配备了12导联ECG，而单导联ECG则不太常见（10.8%，在英国和爱尔兰比例最高）。五分之三的全科医生（59.3%）对根据单导联ECG条带排除AF有信心。通过更多教育（28.7%）和提供模糊心电图追踪建议的远程医疗服务（25.2%）提供帮助会很有帮助。克服诸如（合格）工作人员不足等障碍的首选策略包括将AF筛查与其他医疗保健项目相结合（24.9%）以及识别最适合AF筛查患者的算法（24.3%）。
全科医生认为强烈需要一种标准化的AF筛查方法。可能需要额外资源才能使其广泛应用于临床实践。
