Skip to main navigation
Skip notifications
Access to POEMs and Essential Evidence Plus will no longer be included in CMA membership as of Dec. 1, 2023.
Search
USPSTF 2022 concludes evidence is insufficient to recommend screening for asymptomatic atrial fibrillation (I statement)
Clinical Question
Should primary care clinicians screen for atrial fibrillation in asymptomatic adults without prior stroke?
Bottom line
In this updated 2022 review, the USPSTF continues to conclude that the current evidence is insufficient to recommend for or against screening for AF in otherwise healthy asymptomatic adults, 50 years or older, without a history of stroke (I statement). These recommendations are consistent with the 2018 recommendations. 2c
Reference
Study design: Practice guideline
Funding: Government
Setting: Population-based
Synopsis
In this updated review, the US Preventive Services Task Force (USPSTF) found adequate evidence that intermittent and continuous screening strategies can identify asymptomatic atrial fibrillation (AF) in adults 50 years or older. However, evidence remains uncertain on whether one-time screening is more effective than usual care. In addition, evidence is lacking regarding the balance of benefits versus harms for the treatment of screen-detected (asymptomatic) AF. Anticoagulant therapy may reduce the subsequent risk of stroke but also may result in an increased risk of major bleeding. This review included evidence on multiple screening methods, including electrocardiogram, automated blood pressure cuffs, pulse oximeters, smart watches, and smartphone apps. The American Academy of Family Physicians currently supports the 2018 Task Force recommendations.
Reviewer
David C. Slawson, MD
Professor and Vice Chair of Family Medicine for Education and Scholarship
Atrium Health
Professor of Family Medicine, UNC Chapel Hill
Charlotte, NC
Comments
ATRIAL FIBRILLATION
I try to do a BP and pulse in all my over 50's at least once yearly so often pick up asymptomatic Atrial Fib by doing this. I am not formally screening but do pick up a lot of cases as an irregularity prompts me to do an EKG. Is this not a correct approach?
Atrial fib common
Cva risk
Usual Care
This competes with a previous infopoem recommending screening by taking a pulse.
taking a pulse is so ingrained in routine examinations, that very few physicians will drop it.
But this seems to relate to taking a pulse (or ECG or Holter) when patient is in for another reason altogether.
I doubt that this will change physician routines as the examination itself is low risk
Insufficient evidence for atrial fibrillation screening
With the advent of smart watches, I suspect that many more cases or asymptomatic atrial fibrillation will be identified whether we as physicians go looking for it or not. It would seem as though another clinical trial will be forthcoming - anticoagulation vs Antiplatelet therapy vs no change in current therapy in patients with asymptomatic, self identified, atrial fibrillation.
atrial fib
screening not productive