Identification of patients with atrial fibrillation in general practice: a study of screening methods

Abstract

Atrial fibrillation is common, affecting around 5% of people over 65. 1 2Widespread use of anticoagulants in these patients could greatly reduce the incidence of stroke,3 but many patients are untreated. 2 4Although most people with atrial fibrillation are already recorded as having the condition,4 they may not be easily identifiable from medical records, and this may partly explain the underuse of anticoagulants. As part of a population survey of elderly people we examined two methods for detecting people with atrial fibrillation or flutter: identification of patients currently taking digoxin, and pulse palpation by a trained nurse. Ethical approval was granted by the Northumberland Local Research Ethics Committee. We invited an age and sex stratified sample of 1235 subjects aged 65 years and over, registered with nine contiguous general practices in southern Northumberland, for a screening limb lead electrocardiogram. Subjects were …