10 Aug USPSTF: Unclear If Benefits of Screening for Atrial Fibrillation Outweigh Harms
MedicalResearch.com Interview with:
Seth Landefeld, M.D.
Dr. Landefeld is chairman of the department of medicine and the Spencer chair in medical science leadership at the University of Alabama at Birmingham (UAB) School of Medicine.
Dr. Landefeld also serves on the board of directors of the American Board of Internal Medicine, the UAB Health System, and the University of Alabama Health Services Foundation.
MedicalResearch.com: What is the background for this study? Would you briefly explain what is meant by atrial fibrillation and whom it primarily affects?
Response: Atrial fibrillation—or AF—is an irregular heartbeat. AF affects nearly 3 million Americans and is a leading cause of stroke. Older age and obesity increase the risk of AF, and the condition also occurs more in men than in women. With an aging society and the growing prevalence of obesity in the U.S., this was an important topic for the U.S. Preventive Services Task Force to review.
The Task Force looked at the latest research to see if screening for atrial fibrillation using electrocardiography—or ECG, which is a test that records the activity of someone’s heart—to supplement traditional care is an effective way to diagnose AF and prevent stroke.
We found that more research is needed to determine if screening with ECG can help to identify AF and prevent stroke in adults who are 65 and older and do not have signs or symptoms of the disease.
MedicalResearch.com: What should readers take away from your report?
Response: We need more evidence to determine whether the benefits of screening for atrial fibrillation with ECG outweigh the harms.
However, anyone who is concerned about their risk for atrial fibrillation, or for cardiovascular disease generally, should talk to their clinician. Clinicians should use their best medical judgment when making screening and treatment decisions with adults age 65 and older who do not show signs or symptoms of atrial fibrillation.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: There are several areas where more research is needed before we can make definitive a recommendation about screening for atrial fibrillation. We need randomized trials of people without signs or symptoms that compare the benefits and harms of screening for AF with ECG against a routine exam that includes a clinician checking the patient’s pulse and listening to his or her heart. Additionally, it would be helpful to know more about the relative benefits of screening everyone older than 65 versus checking for AF based on signs or symptoms of the condition.
Finally, we need studies that examine the effectiveness of newer technologies, such as devices that consumers can use to check their heart rate and rhythm.
MedicalResearch.com: Is there anything else you would like to add?
Response: This is the first time the Task Force has published a recommendation on screening for atrial fibrillation with ECG. This recommendation is meant to complement the Task Force’s multiple other recommendations related to cardiovascular disease prevention, which are available on our Web site, www. uspreventiveservicestaskforce. org.
US Preventive Services Task Force. Screening for Atrial Fibrillation With ElectrocardiographyUS Preventive Services Task Force Recommendation Statement. JAMA. 2018;320(5):478–484. doi:10.1001/jama.2018.10321
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