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Atrial fibrillation screening perspectives after STROKESTOP and LOOP

Screening for atrial fibrillation in high-risk populations could contribute to the prevention of cardioembolic stroke. Randomized trials of atrial fibrillation screening are directionally favourable but underpowered for stroke risk assessment; nevertheless, meta-analysis results are encouraging. Consumer-facing wearable devices can detect unknown atrial fibrillation at scale, although they are mostly used by individuals at low risk of stroke.

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Fig. 1: Randomized clinical trials on atrial fibrillation screening.

References

  1. Hart, R. G., Pearce, L. A. & Aguilar, M. I. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann. Intern. Med. 146, 857–867 (2007).

    Article  Google Scholar 

  2. Rillig, A. et al. Early rhythm control in patients with atrial fibrillation and high comorbidity burden. Circulation 146, 836–847 (2022).

    Article  Google Scholar 

  3. Freedman, B. et al. World Heart Federation roadmap on atrial fibrillation – a 2020 update. Glob. Heart 16, 41 (2021).

    Article  Google Scholar 

  4. Sun, W., Freedman, B., Martinez, C., Wallenhorst, C. & Yan, B. P. Atrial fibrillation detected by single time-point handheld electrocardiogram screening and the risk of ischemic stroke. Thromb. Haemost. 122, 286–294 (2022).

    Article  Google Scholar 

  5. Noseworthy, P. A. et al. Artificial intelligence-guided screening for atrial fibrillation using electrocardiogram during sinus rhythm: a prospective non-randomised interventional trial. Lancet 400, 1206–1212 (2022).

    Article  Google Scholar 

  6. Poulter, N. R. et al. May Measurement Month 2017: results of 39 national blood pressure screening programmes. Eur. Heart J. Supp. 21, D1–D4 (2019).

    Article  Google Scholar 

  7. Svennberg, E. et al. Clinical outcomes in systematic screening for atrial fibrillation (STROKESTOP): a multicentre, parallel group, unmasked, randomised controlled trial. Lancet 398, 1498–1506 (2021).

    Article  Google Scholar 

  8. Svendsen, J. H. et al. Implantable loop recorder detection of atrial fibrillation to prevent stroke (the LOOP study): a randomised controlled trial. Lancet 398, 1507–1516 (2021).

    Article  CAS  Google Scholar 

  9. McIntyre, W. F. et al. Screening for atrial fibrillation to prevent stroke: a meta-analysis. Eur. Heart J. Open 2, oeac044 (2022).

    Article  Google Scholar 

  10. Brandes, A. et al. Consumer-led screening for atrial fibrillation: a frontier review of the AF-SCREEN International Collaboration. Circulation 146, 1461–1474 (2022).

    Article  Google Scholar 

Download references

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Correspondence to Renate B. Schnabel.

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Competing interests

B.F. has received speaker fees and travel support for speaking at sessions or official satellites of large international or continental society meetings from Bayer, Bristol-Myers Squibb–Pfizer Alliance, Daiichi Sankyo and Omron; and investigator-initiated research grants to the institution from Bristol-Myers Squibb–Pfizer Alliance. R.B.S. and B.F. have received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme under the grant agreement no. 648131, the European Union’s Horizon 2020 research and innovation programme under the grant agreement no. 847770 (AFFECT-EU). R.B.S. has received funding from the German Center for Cardiovascular Research (DZHK e.V.) (81Z1710103 and 81Z0710114), the German Ministry of Research and Education (BMBF 01ZX1408A), ERACoSysMed3 (031L0239) and Wolfgang Seefried project funding from the German Heart Foundation.

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Freedman, B., Schnabel, R.B. Atrial fibrillation screening perspectives after STROKESTOP and LOOP. Nat Rev Cardiol 20, 1–2 (2023). https://doi.org/10.1038/s41569-022-00803-9

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