Kongebro Emilie Katrine, Kronborg Christian, Xing Lucas Yixi, Haugan Ketil Jørgen, Graff Claus, Højberg Søren, Olesen Morten S, Krieger Derk, Brandes Axel, Køber Lars, Svendsen Jesper Hastrup, Diederichsen Søren Zöga
Department of Cardiology, Copenhagen University Hospital - Rigshospitalet, Inge Lehmanns Vej 7, 2100, Copenhagen, Denmark.
Department of Economics, University of Southern Denmark, Campusvej 56, 5230, Odense.
Eur J Intern Med. 2025 Apr;134:41-50. doi: 10.1016/j.ejim.2024.12.035. Epub 2025 Jan 12.
Screening for atrial fibrillation is rising and may worsen or improve quality of life.
We assessed quality of life (EQ-5D-5L) data in 6,004 participants with stroke risk factors randomised to usual care (n=4,503) or implantable loop recorder with anticoagulation upon detection of atrial fibrillation (n=1,501). Five domains (mobility, selfcare, usual activities, pain/discomfort, anxiety/depression) each scored from one to five were calculated into individual index scores (worst=-0.76, best=1.00). Changes in the index score and the visual analogue scale score (EQ VAS (0=worst, 100=best)) from baseline to year three were the primary outcomes, which were analysed using linear mixed models. Major problem was defined as a domain score ≥3 and analysed with logistic regression in year three.
Of 6,004 participants, 5,733 (95 %) were alive after three years, and 5,162 (86 %) had complete EQ-5D-5L data. The baseline index score of 5,733 participants was 0.88 ±0.16, which decreased by -0.05 (-0.05; -0.04) in the control vs -0.04 (-0.05; -0.03) in the screening group after three years, and a baseline EQ VAS score of 78.4±16.2, which decreased by -6.06 (-6.54; -5.57) in control vs -5.18 (-5.95; -4.40) in the screening group after three years, with no significant difference between the groups (p=0.063 and p=0.056, respectively). The most frequent problem was major pain/discomfort (1,202 of 5,162 (23.3 %)), and any major problem occurred equally in the groups after three years (OR 0.91 (0.79;1.05)).
A population-based, long-term, and continuous screening for atrial fibrillation in high-risk individuals did not translate into increased quality of life.
