title: Opportunistic screening for atrial fibrillation in a rural area.
abstract: BACKGROUND
  Opportunistic screening is an effective means of identifying subjects with Atrial Fibrillation (AF). Previous studies of opportunistic screening have been performed areas with high population density and before the development of novel oral anticoagulant drugs. We performed a study to determine feasibility of AF screening in a predominantly rural, low population density area.
  
  
  METHODS
  Over 6 months, subjects 65 years and older were screened by local General Practitioners using radial pulse palpation confirmed by 12 lead Electrocardiogram. Data were recorded electronically and those with newly identified AF were followed up to examine management post diagnosis.
  
  
  RESULTS
  In total, 7262 subjects were screened and an irregular pulse was found in 916 (12.6%) of whom 735 (10.1%) had known AF and 55 (0.76%) had newly detected AF. Of these 55 patients with newly documented AF, 28 (50.9%) were women, 38 (69.1%) had hypertension and eight (14.5%) had a smoking history. Mean body mass index in subjects with newly documented AF was 28.9 kg/m(2)(SD 5.6) There was no significant difference in gender mix (P =  0.4), smoking history (P  =  0.8) or alcohol history (P  =  0.8) with the overall population. Fifty-one (92.7%) subjects had a CHA2DS2VaSC score  ≥ 2 of whom 33 (64.7%) were eventually anticoagulated and nine (17.6%) commenced on Aspirin. The rate of newly identified patients in AF was lower than in previous reported key studies because of a higher rate of subjects with known AF.
  
  
  CONCLUSIONS
  Opportunistic AF screening in a rural environment identified a substantial number of new cases, although less than in previous screening studies.
authors.affiliation: From the 1Department of Public Health, National Clinical Programme for Stroke, Galway, Ireland.
authors.forename: B
authors.initials: B
authors.lastname: Smyth
authors.affiliation: Department of Public Health, National Clinical Programme for Stroke, Tullamore, Ireland.
authors.forename: P
authors.initials: P
authors.lastname: Marsden
authors.affiliation: From the 1Department of Public Health, National Clinical Programme for Stroke, Galway, Ireland.
authors.forename: R
authors.initials: R
authors.lastname: Corcoran
authors.affiliation: National Clinical Programme for Stroke, Department of Cardiology University College Hospital, Galway, Ireland.
authors.forename: R
authors.initials: R
authors.lastname: Walsh
authors.affiliation: Department of Public Health, National Clinical Programme for Stroke, Tullamore, Ireland.
authors.forename: C
authors.initials: C
authors.lastname: Brennan
authors.affiliation: Health Service Executive, Practice Nursing, National Clinical Programme for Stroke, Mayo, Ireland.
authors.forename: K
authors.initials: K
authors.lastname: McSharry
authors.affiliation: Health Service Executive, National Clinical Programme for Primary Care, Summerhill Meath, Ireland.
authors.forename: J
authors.initials: J
authors.lastname: Clarke
authors.affiliation: Department of Neurology UCD, National Clinical Programme for Stroke, Dublin, Ireland.
authors.forename: P J
authors.initials: PJ
authors.lastname: Kelly
authors.affiliation: Department of Medical Gerontology Trinity College Dublin, National Clinical Programme for Stroke, Dublin, Ireland.
authors.forename: J
authors.initials: J
authors.lastname: Harbison
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology*; D015716:Electrocardiography, Ambulatory; D005260:Female; D006801:Humans; D007494:Ireland / Q000453:epidemiology; D008297:Male; D008403:Mass Screening / Q000379:methods*; D012424:Rural Population; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin
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