Asymptomatic atrial fibrillation (AF) is associated with similar stroke risk as symptomatic AF, yet is often detected only after the patient presents with a devastating stroke. The first Australian guidelines for the screening and management of AF were released in 2018 by the National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand. This brief, practical summary of the guidelines focuses on screening in general practice.
- Atrial fibrillation (AF) is the most common heart arrhythmia, and is associated with a fivefold increased risk of stroke.
- AF increases markedly in prevalence after 65 years of age and often occurs in patients with multiple comorbidities.
- Opportunistic single-time point AF screening detects asymptomatic (‘silent’) and largely persistent AF, which confers similar stroke risk as the symptomatic form.
- Australian guidelines recommend opportunistic screening for AF in all people aged 65 years and older.
- Opportunistic screening can be incorporated easily and with minimal cost in routine patient care in general practice. New systems and technologies are being developed to overcome time barriers to screening in general practice.
- Significant reductions in preventable stroke can be achieved if AF screening works hand in hand with the provision of treatment and efforts to facilitate patient adherence.