Screening for Atrial Fibrillation: Risks, Benefits, and Implications On Future Clinical Practice

Atrial fibrillation (AF) is the most commonly encountered arrhythmia in clinical practice with constantly rising prevalence due to an overall increased ageing population with multiple co-morbidities. Since AF predisposes patients to debilitating and life-threatening complications such as stroke and coronary artery disease (CAD), much emphasis has been placed recently on early recognition and management of the disease to prevent complications. Hence, the focus of this review is deliberate on the potential risks and benefits of screening initiatives for AF and their ultimate impact on healthcare systems the associated disease burden.

Due to lack of clarity on the matter, implementation of national screening programmes for AF are not currently recommended by health authorities in the UK and USA. Nevertheless, recent multicentre studies such as AF-SCREEN and STROKESTOP have concluded that select groups may benefit from screening for this disease. Research in the use of electrocardiographs (ECGs) and wearable smart devices for early detection of AF has also demonstrated a marked decrease in AF-associated thromboembolic events

Although there is a dire need for further robust clinical trials to investigate various screening modalities and develop a robust criterion for AF screening, current literature supports the implementation of a national screening programme to combat the rate of AF-associated complications which continue to challenge the healthcare system.