- Design
- Single-centre cross-sectional screening study
- Population
- 357 adults aged 65 and over attending a family health centre in Türkiye
- Primary outcome
- Prevalence of AF on a single 12-lead ECG
- Effect
- 11.8% (8.8–15.5); 6.2% previously unrecognised; 5.6% unrecognised and eligible but untreated
A single-centre study in a family health centre in Istanbul offered a 12-lead ECG to consecutive adults aged 65 and over. Of 357 screened, 42 had atrial fibrillation (11.8%, 95% CI 8.8–15.5), rising to about a quarter of those aged 80 and over. Twenty-two of the 42 had no prior diagnosis — 6.2% of everyone screened.
Most people with atrial fibrillation (88%) met the anticoagulation threshold used in the study, and 18 of those with unrecognised AF were untreated: 5.6% of all screened. Heart failure and chronic lung disease were associated with detection.
This is one clinic, one ECG, and a cross-sectional design. The authors are clear that it shows yield, not benefit: it does not establish that screening reduces strokes. Prevalence here is high, and may not transfer to younger or healthier populations.
- Check the pulse of older patients opportunistically, especially those with heart failure or lung disease.
- Consider a 12-lead ECG when the pulse is irregular or the history suggests palpitations.
- Calculate stroke risk for any newly found atrial fibrillation and discuss anticoagulation.
- This study measured how much AF is found, not whether finding it prevents strokes.
Why it matters
Half of atrial fibrillation in this clinic was unknown until someone looked.
Don't overread it
A one-centre prevalence study does not show that screening reduces stroke.
The statistics, in plain English
The 95% confidence interval for prevalence (8.8% to 15.5%) shows the uncertainty from a sample of 357. Odds ratios for heart failure and lung disease come from an exploratory model with few events, so their intervals are wide.
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