title: EARLY: a pilot study on early diagnosis of atrial fibrillation in a primary healthcare centre.
abstract: OBJECTIVE
  Atrial fibrillation (AF) is associated with high morbidity and mortality. Early diagnosis is likely to improve therapy and prognosis. The study objective was to evaluate the usefulness of a programme for early diagnosis of AF in patients from an urban primary care centre.
  
  
  RESULTS
  Participants were recruited from a randomized sample of patients not diagnosed with AF but having relevant risk factors: age ≥ 65 years, ischaemic and/or valvular heart disease, congestive heart failure, hypertension, and/or diabetes. Patients were randomly assigned to the intervention group (IG) or control group (CG). The intervention included (i) initial visit with clinical history, electrocardiogram, and instruction about pulse palpation and warning signs and (ii) electrocardiogram every 6 months during a 2-year follow-up. The main endpoint of the study was the proportion of new cases diagnosed at 6 months. Secondary endpoints were number of new AF diagnoses and complications associated with the arrhythmia in both groups. A total of 928 patients were included (463 IG and 465 CG). At 6 months, AF was diagnosed in 8 IG patients and 1 CG patient (1.7 vs. 0.2%, respectively, P = 0.018). After 2 years of follow-up, 11 IG patients and 6 CG patients had newly diagnosed AF (2.5 vs. 1.3%, respectively, P = 0.132). Time to first diagnosis of AF was shorter in IG patients [median (inter-quartile range): 7 (192) days vs. 227 (188.5) days in CG, P = 0.029].
  
  
  CONCLUSIONS
  The simple screening proposed could be useful for the early detection of AF in primary care.
authors.affiliation: Unitat de Fibril·lació Auricular (UFA), Hospital Clínic, Universitat de Barcelona, Villarroel 170, Barcelona, Catalonia 08036, Spain CAPSBE Les Corts Barcelona, Catalonia, Spain.
authors.forename: Luisa
authors.initials: L
authors.lastname: Benito
authors.affiliation: Unitat de Fibril·lació Auricular (UFA), Hospital Clínic, Universitat de Barcelona, Villarroel 170, Barcelona, Catalonia 08036, Spain Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.
authors.forename: Blanca
authors.initials: B
authors.lastname: Coll-Vinent
authors.affiliation: Unitat de Fibril·lació Auricular (UFA), Hospital Clínic, Universitat de Barcelona, Villarroel 170, Barcelona, Catalonia 08036, Spain CAPSBE Les Corts Barcelona, Catalonia, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Gómez
authors.affiliation: Unitat de Fibril·lació Auricular (UFA), Hospital Clínic, Universitat de Barcelona, Villarroel 170, Barcelona, Catalonia 08036, Spain CAPSBE Les Corts Barcelona, Catalonia, Spain.
authors.forename: David
authors.initials: D
authors.lastname: Martí
authors.affiliation: Unitat de Fibril·lació Auricular (UFA), Hospital Clínic, Universitat de Barcelona, Villarroel 170, Barcelona, Catalonia 08036, Spain CAPSBE Les Corts Barcelona, Catalonia, Spain.
authors.forename: Joan
authors.initials: J
authors.lastname: Mitjavila
authors.affiliation: Unitat de Fibril·lació Auricular (UFA), Hospital Clínic, Universitat de Barcelona, Villarroel 170, Barcelona, Catalonia 08036, Spain CAPSBE Les Corts Barcelona, Catalonia, Spain.
authors.forename: Ferran
authors.initials: F
authors.lastname: Torres
authors.affiliation: Unitat de Fibril·lació Auricular (UFA), Hospital Clínic, Universitat de Barcelona, Villarroel 170, Barcelona, Catalonia 08036, Spain Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain.
authors.forename: Òscar
authors.initials: Ò
authors.lastname: Miró
authors.affiliation: Unitat de Fibril·lació Auricular (UFA), Hospital Clínic, Universitat de Barcelona, Villarroel 170, Barcelona, Catalonia 08036, Spain CAPSBE Les Corts Barcelona, Catalonia, Spain.
authors.forename: Antoni
authors.initials: A
authors.lastname: Sisó
authors.affiliation: Unitat de Fibril·lació Auricular (UFA), Hospital Clínic, Universitat de Barcelona, Villarroel 170, Barcelona, Catalonia 08036, Spain Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Catalonia, Spain lmont@clinic.cat.
authors.forename: Lluís
authors.initials: L
authors.lastname: Mont
mesh_terms: D000368:Aged; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D042241:Early Diagnosis; D004562:Electrocardiography; D005260:Female; D006268:Health Facilities; D006801:Humans; D008297:Male; D008487:Medical History Taking; D010808:Physical Examination; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011320:Primary Health Care; D011379:Prognosis; D015397:Program Evaluation; D018570:Risk Assessment; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D013997:Time Factors; D019037:Urban Health Services
keywords: Atrial fibrillation; Early diagnosis; Primary health care