- Design
- Single-centre cross-sectional screening study
- Population
- 357 adults aged 65 or over at a family health centre
- Primary outcome
- Prevalence of AF on a single 12-lead ECG
- Effect
- 11.8% (95% CI 8.8–15.5); 6.2% previously unrecognised; 20 eligible but not anticoagulated
A Turkish family health centre offered a single 12-lead ECG to 357 consecutive adults aged 65 or over. Atrial fibrillation was found in 42 (11.8%), rising to 26% in those over 80. Twenty-two cases (6.2% of everyone screened) were previously unrecognised.
Most people with AF (88%) met the threshold to consider anticoagulation, yet 20 were not taking it — 18 of them among the newly found cases. Heart failure and chronic lung disease were the strongest associated features.
This is one centre, and finding AF on screening is not the same as showing that screening prevents strokes. But it shows how much unrecognised, untreated AF sits in a routine older population — which supports simple opportunistic checks, a pulse at every visit or an ECG when one is easy to do.
- Feel the pulse of every patient over 65 at routine visits
- Consider an ECG when the pulse is irregular or the patient has heart failure or lung disease
- Calculate CHA₂DS₂-VASc for anyone found to have AF and discuss anticoagulation
- Check that known AF patients who meet the threshold are actually anticoagulated
Why it matters
Unrecognised AF in older patients is common enough to find in an ordinary clinic morning.
Don't overread it
A single-centre prevalence study does not show that screening prevents strokes.
The statistics, in plain English
The 95% confidence interval for prevalence, 8.8% to 15.5%, reflects the small sample; the true rate in similar clinics could be anywhere in that range.
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