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Can we mass screen for AF among those aged over 75 in Australia?

Professor Clara Chow, Institution: University of Sydney

2019 Vanguard Grant

Years funded: 2020-2021


Atrial fibrillation (AF) is common, especially among the elderly, and carries a high associated risk of stroke. Prevalence of AF increases with age, and studies outside of Australia suggest screening of populations ≥75 years yields detection rates of new AF of around 5%, with higher detection rates in patients with co-existing risk factors, monitored for longer periods of time and using methods that obtains a medical quality ECG tracing, such as with a handheld device. Several national and international guidelines are now encouraging AF screening; however, implementation of these guidelines still faces two challenges, developing a sustainable strategy for AF screening in populations and ensuring appropriate treatment for newly diagnosed AF. There are approximately 1.5 million people in Australia over the age of 75, and their life expectancy is over 10 years. Is a mass population approach for AF screening in this patient population feasible?

The objective of this research is to examine a strategy of AF screening for over 75s, that is integrated with cardiac services - centres that currently monitor patients with pacemakers and that could arrange rapid and appropriate access to AF management services if required. We propose to use a targeted health promotion campaign to enrol community-dwellers aged 75 or older. We will provide mobile handheld ECG devices with training and couple this with a reminder system to facilitate daily ECG monitoring and sending of data to the cardiovascular centre. Within the cardiovascular centre we will implement a clinical algorithm aligned with current AF management guidelines for suspected AF or newly diagnosed AF to access AF management services.

This research will pilot the strategy and examine participant acceptability, AF detection rate and costs of the program.

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