Clinical outcomes in systematic screening for atrial fibrillation (STROKESTOP): a multicentre, parallel group, unmasked, randomised controlled trial
This Swedish RCT (n=28,768) found fewer ischaemic or haemorrhagic stroke, systemic embolism, bleeding leading to hospitalisation and all-cause death events in the atrial fibrillation screening group compared to the control group (31.9% vs 33%; HR 0.96; 95% CI 0.92–1.00, p=0·045).
Source:
The Lancet
SPS commentary:
Two related commentaries discuss the findings of this trial. The first discusses the evidence from previous trials providing rationale for European guidelines recommendation for single-timepoint atrial fibrillation (AF) screening and current lack of evidence of higher intensity AF screening and AF screening with an electrocardiogram, noting the need for randomised controlled trials with hard endpoints to show the long term outcomes of screening for widespread adoption. The second commentary discusses guideline recommended single-timepoint screening for AF conducted by taking the pulse or by handheld electrocardiogram in primary care, noting that although routine practice it is infrequently performed, It also covers stroke reduction by oral anticoagulant thromboprophylaxis .