title: Mass Screening for Untreated Atrial Fibrillation: The STROKESTOP Study.
abstract: BACKGROUND
  The aims of the present study were to define the prevalence of untreated atrial fibrillation (AF) in a systematic screening program using intermittent ECG recordings among 75- to 76-year-old individuals and to study the feasibility of initiating protective oral anticoagulant (OAC) treatment.
  
  
  RESULTS
  Half of the 75- to 76-year-old population in 2 Swedish regions were invited to a screening program for AF. Participants without a previous diagnosis of AF underwent intermittent ECG recordings over 2 weeks. If AF was detected, participants were offered OAC. During the 28-month inclusion period, 13 331 inhabitants were invited. Of these, 7173 (53.8%) participated. Of the participants, 218 (3.0%; 95% confidence interval [CI], 2.7-3.5) were found to have previously unknown AF, and of these, AF was found in 37 (0.5% of the screened population) on their first ECG. The use of intermittent ECGs increased new AF detection 4-fold. A previous diagnosis of AF was known in 9.3% (n=666; 95% CI, 8.6-10.0). Total AF prevalence in the screened population was 12.3%. Of participants with known AF, 149 (2.1%; 95% CI, 1.8-2.4) had no OAC treatment. In total, 5.1% (95% CI, 4.6-5.7) of the screened population had untreated AF; screening resulted in initiation of OAC treatment in 3.7% (95% CI, 3.3-4.2) of the screened population. More than 90% of the participants with previously undiagnosed AF accepted initiation of OAC treatment.
  
  
  CONCLUSIONS
  Mass screening for AF in a 75- to 76-year-old population identifies a significant proportion of participants with untreated AF. Initiation of stroke prophylactic treatment was highly successful in individuals with newly diagnosed AF.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT01593553.
authors.affiliation: From Karolinska Institutet, Department of Clinical Sciences, Cardiology Unit, Danderyd's University Hospital, Stockholm, Sweden (E.S., F.A.-K., L.F., V.F., M.R.); Department of Medicine, Halland's Hospital, Halmstad, Sweden (J.E.); and Stockholm Heart Center, Sweden (F.A.-K.). emma.svennberg@ds.se.
authors.forename: Emma
authors.initials: E
authors.lastname: Svennberg
authors.affiliation: From Karolinska Institutet, Department of Clinical Sciences, Cardiology Unit, Danderyd's University Hospital, Stockholm, Sweden (E.S., F.A.-K., L.F., V.F., M.R.); Department of Medicine, Halland's Hospital, Halmstad, Sweden (J.E.); and Stockholm Heart Center, Sweden (F.A.-K.).
authors.forename: Johan
authors.initials: J
authors.lastname: Engdahl
authors.affiliation: From Karolinska Institutet, Department of Clinical Sciences, Cardiology Unit, Danderyd's University Hospital, Stockholm, Sweden (E.S., F.A.-K., L.F., V.F., M.R.); Department of Medicine, Halland's Hospital, Halmstad, Sweden (J.E.); and Stockholm Heart Center, Sweden (F.A.-K.).
authors.forename: Faris
authors.initials: F
authors.lastname: Al-Khalili
authors.affiliation: From Karolinska Institutet, Department of Clinical Sciences, Cardiology Unit, Danderyd's University Hospital, Stockholm, Sweden (E.S., F.A.-K., L.F., V.F., M.R.); Department of Medicine, Halland's Hospital, Halmstad, Sweden (J.E.); and Stockholm Heart Center, Sweden (F.A.-K.).
authors.forename: Leif
authors.initials: L
authors.lastname: Friberg
authors.affiliation: From Karolinska Institutet, Department of Clinical Sciences, Cardiology Unit, Danderyd's University Hospital, Stockholm, Sweden (E.S., F.A.-K., L.F., V.F., M.R.); Department of Medicine, Halland's Hospital, Halmstad, Sweden (J.E.); and Stockholm Heart Center, Sweden (F.A.-K.).
authors.forename: Viveka
authors.initials: V
authors.lastname: Frykman
authors.affiliation: From Karolinska Institutet, Department of Clinical Sciences, Cardiology Unit, Danderyd's University Hospital, Stockholm, Sweden (E.S., F.A.-K., L.F., V.F., M.R.); Department of Medicine, Halland's Hospital, Halmstad, Sweden (J.E.); and Stockholm Heart Center, Sweden (F.A.-K.).
authors.forename: Mårten
authors.initials: M
authors.lastname: Rosenqvist
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D011446:Prospective Studies; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology* / Q000517:prevention & control*; D013548:Sweden / Q000453:epidemiology
keywords: anticoagulants; atrial fibrillation; mass screening; prevention and control; stroke