@article{22942,
  author = {Anderson Craig and Wang Jiguang and Hillis Graham and Neubeck Lis and Gwynne Kylie and Hankey Graeme and Freedman Ben and Camm John and Calkins Hugh and Healey Jeffrey and Rosenqvist Mårten and Albert Christine and Antoniou Sotiris and Benjamin Emelia and Boriani Giuseppe and Brachmann Johannes and Brandes Axel and Chao Tze-Fan and Conen David and Engdahl Johan and Fauchier Laurent and Fitzmaurice David and Friberg Leif and Gersh Bernard and Gladstone David and Glotzer Taya and Harbison Joseph and Hills Mellanie and Kamel Hooman and Kirchhof Paulus and Kowey Peter and Krieger Derk and W Y Lee Vivian and Levin Lars-Åke and Lip Gregory and Lobban Trudie and Lowres Nicole and Mairesse Georges and Martinez Carlos and Orchard Jessica and Piccini Jonathan and Poppe Katrina and Potpara Tatjana and Puererfellner Helmut and Rienstra Michiel and Sandhu Roopinder and Schnabel Renate and Siu Chung-Wah and Steinhubl Steven and Svendsen Jesper and Svennberg Emma and Themistoclakis Sakis and Tieleman Robert and Turakhia Mintu and Tveit Arnljot and Uittenbogaart Steven and Van Gelder Isabelle and Verma Atul and Wachter Rolf and Yan Bryan and AF-Screen Collaborators},
  title = {Screening for Atrial Fibrillation: A Report of the AF-SCREEN International Collaboration.},
  abstract = {<p>
Approximately 10% of ischemic strokes are associated with atrial fibrillation (AF) first diagnosed at the time of stroke. Detecting asymptomatic AF would provide an opportunity to prevent these strokes by instituting appropriate anticoagulation. The AF-SCREEN international collaboration was formed in September 2015 to promote discussion and research about AF screening as a strategy to reduce stroke and death and to provide advocacy for implementation of country-specific AF screening programs. During 2016, 60 expert members of AF-SCREEN, including physicians, nurses, allied health professionals, health economists, and patient advocates, were invited to prepare sections of a draft document. In August 2016, 51 members met in Rome to discuss the draft document and consider the key points arising from it using a Delphi process. These key points emphasize that screen-detected AF found at a single timepoint or by intermittent ECG recordings over 2 weeks is not a benign condition and, with additional stroke factors, carries sufficient risk of stroke to justify consideration of anticoagulation. With regard to the methods of mass screening, handheld ECG devices have the advantage of providing a verifiable ECG trace that guidelines require for AF diagnosis and would therefore be preferred as screening tools. Certain patient groups, such as those with recent embolic stroke of uncertain source (ESUS), require more intensive monitoring for AF. Settings for screening include various venues in both the community and the clinic, but they must be linked to a pathway for appropriate diagnosis and management for screening to be effective. It is recognized that health resources vary widely between countries and health systems, so the setting for AF screening should be both country- and health system-specific. Based on current knowledge, this white paper provides a strong case for AF screening now while recognizing that large randomized outcomes studies would be helpful to strengthen the evidence base.
</p>
},
  year = {2017},
  journal = {Circulation},
  volume = {135},
  pages = {1851-1867},
  issn = {1524-4539},
  doi = {10.1161/CIRCULATIONAHA.116.026693},
  language = {eng},
}