Effectiveness of a nongovernmental organization–led large-scale community atrial fibrillation screening program using the smartphone electrocardiogram: An observational cohort study
| Autor: | Ngai-Yin Chan, Chi-Chung Choy, Chung-Wah Siu, Chi-Kin Chan |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty 030204 cardiovascular system & hematology Risk Assessment Asymptomatic Electrocardiography 03 medical and health sciences 0302 clinical medicine Risk Factors Physiology (medical) Internal medicine Atrial Fibrillation medicine Humans Mass Screening Community Health Services 030212 general & internal medicine Stroke Mass screening Aged Retrospective Studies Aged 80 and over business.industry Retrospective cohort study Atrial fibrillation medicine.disease Confidence interval Hong Kong Female Smartphone Morbidity medicine.symptom Cardiology and Cardiovascular Medicine business Risk assessment Cohort study |
| Zdroj: | Heart Rhythm. 15:1306-1311 |
| ISSN: | 1547-5271 |
| DOI: | 10.1016/j.hrthm.2018.06.006 |
| Popis: | Background Opportunistic screening for atrial fibrillation (AF) in patients older than 65 years is currently recommended. Objective We aim to examine the effectiveness of a nongovernmental organization–led community-based AF screening program carried out by trained layperson volunteers. Methods AF screening was performed using a smartphone electrocardiogram in 11,574 participants. Results Among all participants, smartphone electrocardiograms were interpretable in 10,735 citizens (92.8%; 8564 female citizens [79.8%]; mean age 78.6 ± 8.1 years). Two hundred forty-four participants (2.3%; 95% confidence interval [CI] 2–2.6%; 172 female participants [70.5%]; mean age 79.5 ± 7.9 years) had AF and were advised over phone by a nurse to seek medical attention. Newly diagnosed AF was found in 74 participants (0.69%; 95% CI 0.54–0.84%) with a mean CHA2DS2-VASc score of 3.9 ± 1.5. Thirty-six of them (48%; 95% CI 36.6–59.4%) were asymptomatic. The number needed to screen for 1 newly diagnosed AF was 145. Telephone follow-up of participants with AF was conducted 9 months after screening. Of 72 participants with newly diagnosed AF and indicated for oral anticoagulation, 47 (65.3%; 95% CI 54.3–76.3%) sought medical attention, 17 (23.6%; 95% CI 13.8–33.4%) received oral anticoagulants, and 16 (22.2%; 95% CI 12.6–31.8%) had 100% compliance. The number needed to screen for 1 appropriately treated newly diagnosed AF was 671. Conclusion This nongovernmental organization–led community-based AF screening program is effective in identifying citizens with newly diagnosed AF. However, the effectiveness of the program in subsequently leading them to receive appropriate oral anticoagulation therapy is weakened by the lack of a more structured downstream management pathway. |
| Databáze: | OpenAIRE |
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