Atrial fibrillation: a comparison of methods to identify cases in general practice.
The importance of atrial fibrillation as a treatable risk factor for stroke is well established. Less is known about how to find previously unidentified cases within the community so that antithrombotic treatment can be offered to a wider group of at-risk patients. The aim of our study was to examine ways to improve the efficiency of practice-based screening for atrial fibrillation, including issues of time and financial cost. We used different combinations of pulse palpation and interpretation of 12-lead and bipolar electrocardiographs as carried out by practice nurses. The best strategy for the detection of atrial fibrillation in a practice population would appear to be to screen all eligible subjects by nurse pulse palpation, followed by 12-lead electrocardiograph readings in those who have a pulse suggestive of atrial fibrillation. The electrocardiograph interpretation can be undertaken effectively by a trained nurse.
Somerville
S
S
Primary Care Sciences Research Centre, Keele University School of Postgraduate Medicine, Stoke-on-Trent. simon@somerville22.freeserve.co.uk
Somerville
J
J
Croft
P
P
Lewis
M
M
D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000451:nursing; D004562:Electrocardiography; D005194:Family Practice / Q000458:organization & administration / Q000592:standards; D006801:Humans; D009722:Nurse Practitioners / Q000592:standards; D012680:Sensitivity and Specificity; D016896:Treatment Outcome