USPSTF: Not enough evidence to provide atrial fibrillation screening recommendation
The U.S. Preventive Services Task Force announced there is insufficient evidence to make a recommendation on screening asymptomatic patients aged 50 years and older for atrial fibrillation.
Patients with atrial fibrillation have a five-fold increased risk for ischemic stroke, according to the USPSTF. In addition, the American Heart Association says atrial fibrillation can lead to heart failure and other heart-related complications.
“It is important to remember that task force recommendations apply to people with no signs or symptoms of the condition in question,” Gbenga Ogedegbe, MD, MPH, a task force member and director of the Center for Healthful Behavior Change at the NYU Grossman School of Medicine, told Healio Primary Care. “We are calling for more research on this important topic in the hope that we will be able to make a strong, evidence-based recommendation in the future.”
According to Ogedegbe and the evidence review authors, more studies are needed to juxtapose the benefits and harms of screening for atrial fibrillation against usual care and to assess early atrial fibrillation treatment benefits as well as early rate and rhythm control in screen-detected, asymptomatic persons. Until then, Ogedegbe said physicians may find prior USPSTF recommendations regarding behavioral counseling to promote a healthy lifestyle in adults with CVD risk factors and hypertension screening in adults useful.
“It is important to note that the task force considers taking someone’s pulse during a routine medical visit as part of usual care. If an unusual heartbeat is detected, clinicians can often use an electrocardiogram to help make a diagnosis,” Ogedegbe said. “As always, we advise clinicians to use their medical judgement on both whether or not to screen and how to screen for atrial fibrillation.”
The public can comment on the draft recommendation on the USPSTF’s website through May 17.
American Heart Association. What is atrial fibrillation (or Afib or AF)? https://www.heart.org/en/health-topics/atrial-fibrillation/what-is-atrial-fibrillation-afib-or-af#. Accessed April 16, 2021.
Kahwati L, et al. Screening for atrial fibrillation: An evidence review for the U.S. Preventive Services Task Force. https://www.uspreventiveservicestaskforce.org/uspstf/document/draft-evidence-review/screening-atrial-fibrillation. Accessed April 20, 2021.
USPSTF. Screening for atrial fibrillation: U.S. Preventive Services Task Force draft recommendation statement. https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/screening-atrial-fibrillation. Accessed April 20, 2021.