Newly diagnosed atrial fibrillation detected by noninvasive screening methods in clinical practice.

BACKGROUND

Patient characteristics and outcomes of newly diagnosed atrial fibrillation (AF) have been investigated in large registries.

OBJECTIVE

The study aimed to address the role of non-invasive screening tools in diagnosing AF in the Argentinian clinical practice.

METHODS

This was an observational retrospective study. Patients' clinical characteristics and management of newly diagnosed AF detected by a non-invasive screening tool were analyzed.

RESULTS

Of 12,635 AF outpatients, 1018/5947 (17.1%) of newly diagnosed AF were detected by a screening method: electrocardiography monitoring device (82.3%), self-pulse palpation (17.3%), and smartwatch/smartphone (0.4%).Screening (+) patients were older (73 years [63-81] vs 72 [65-81], = not significant) and had a higher prevalence of ≥ 75 year-old patients (45.5% vs 37.9%, < .001) and women (42.5% vs 41.2%, = not significant).Adjusted results (odds ratio [95% confidence interval]) by multivariate analysis showed that alcohol consumption (1.74 [1.14-2.65]), thyroid dysfunction (1.26 [1.07-1.49]), coronary artery disease (1.40 [1.19-1.64]), paroxysmal AF (2.39 [1.94-2.96]), asymptomatic condition (2.44 [2.07-2.86]), high risk of thromboembolic and bleeding complications (CHADS-Vasc, 1.18 [1.06-1.32] and HASBLED, 1.25 [1.08-1.46]), and heart failure (1.23 [1.01-1.49]) were associated with screening (+) patients. Although no difference in the oral anticoagulation therapy was detected, vitamin K antagonists were less frequently prescribed (0.66 [0.53-0.82]). Electrical cardioversion was preferred over class I and III antiarrhythmic drugs (1.33 [1.07-1.66] vs 0.61 [0.44-0.84] and 0.79 [0.64-0.97]).

CONCLUSION

Non-invasive screening tools are mainly used in Argentinian clinical practice to detect AF in asymptomatic patients at high risk of thromboembolic and bleeding complications. Vitamin K antagonists are less prescribed, and electrical cardioversion is preferred over antiarrhythmic drugs for initial rhythm control.