Ten‐year trends in prescribing of antiarrhythmic drugs in Australian primary care patients with atrial fibrillation

2021 ◽  
Vol 51 (10) ◽  
pp. 1732-1735
Author(s):  
Woldesellassie M. Bezabhe ◽  
Luke R. Bereznicki ◽  
Jan Radford ◽  
Mohammed S. Salahudeen ◽  
Edward Garrahy ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Antiarrhythmic Drugs ◽  
Primary Care Patients

scholarly journals Electrocardiographic screening in primary care for cardiovascular disease risk and atrial fibrillation

2019 ◽  
Vol 20 ◽  
Author(s):  
Ralf E. Harskamp
Keyword(s):  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Primary Care ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Diagnostic Testing ◽  
Routine Care ◽  
Pulse Palpation ◽  
Primary Care Patients ◽  
Ecg Abnormalities

Abstract Electrocardiograms (ECGs) are frequently recorded in primary care for screening purposes. An ECG is essential in diagnosing atrial fibrillation, and ECG abnormalities are associated with cardiovascular events. While recent studies show that ECGs adequately reclassify a proportion of patients based on the clinical risk score calculations, there are no data to support that this also results in improved health outcomes. When applied for screening for atrial fibrillation, more cases are found with routine care, but this would be undone when physicians would perform systematic pulse palpation. In most studies, the harms of routine ECG use (such as unnecessary diagnostic testing, emotional distress, increased health expenses) were poorly documented. As such, the routine performing of ECGs in asymptomatic primary care patients, whether it is for cardiovascular disease risk assessment or atrial fibrillation, cannot be recommended.

Prevalence and characteristics of OSAFED syndrome in atrial fibrillation primary care patients

2017 ◽  
pp. 432-438 ◽  
Author(s):  
Jacek Wolf ◽  
Tadeusz Dereziński ◽  
Anna Szyndler ◽  
Krzysztof Narkiewicz
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Primary Care Patients

scholarly journals Atrial fibrillation detection in primary care during blood pressure measurements and using a smartphone cardiac monitor

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
John D. Sluyter ◽  
Robert Scragg ◽  
Malakai ‘Ofanoa ◽  
Ralph A. H. Stewart
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Primary Care ◽  
Discrimination Performance ◽  
Screening Methods ◽  
Net Benefit ◽  
Pulse Rate Variability ◽  
Cardiac Monitor ◽  
Primary Care Patients ◽  
Blood Pressure Device

AbstractImproved atrial fibrillation (AF) screening methods are required. We detected AF with pulse rate variability (PRV) parameters using a blood pressure device (BP+; Uscom, Sydney, Australia) and with a Kardia Mobile Cardiac Monitor (KMCM; AliveCor, Mountain View, CA). In 421 primary care patients (mean (range) age: 72 (31–99) years), we diagnosed AF (n = 133) from 12-lead electrocardiogram recordings, and performed PRV and KMCM measurements. PRV parameters detected AF with area under curve (AUC) values of up to 0.92. Using the mean of two sequential readings increased AUC to up to 0.94 and improved positive predictive value at a given sensitivity (by up to 18%). The KMCM detected AF with 83% sensitivity and 68% specificity. 89 KMCM recordings were “unclassified” or blank, and PRV detected AF in these with AUC values of up to 0.88. When non-AF arrhythmias (n = 56) were excluded, the KMCM device had increased specificity (73%) and PRV had higher discrimination performance (maximum AUC = 0.96). In decision curve analysis, all PRV parameters consistently achieved a positive net benefit across the range of clinical thresholds. In primary care, AF can be detected by PRV accurately and by KMCM, especially in the absence of non-AF arrhythmias or when combinations of measurements are used.

Atrial fibrillation detection with a portable device during cardiovascular screening in primary care

Heart ◽  
2020 ◽  
Vol 106 (16) ◽  
pp. 1261-1266 ◽  
Author(s):  
Adriana C Diamantino ◽  
Bruno R Nascimento ◽  
Andrea Z Beaton ◽  
Maria Carmo P Nunes ◽  
Kaciane K B Oliveira ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Heart Disease ◽  
High Risk ◽  
High Sensitivity ◽  
Low Risk ◽  
Intermediate Risk ◽  
Complete Study ◽  
Risk Patients ◽  
Primary Care Patients

IntroductionA novel handheld dual-electrode stick is a portable atrial fibrillation (AF) screening device (AFSD). We evaluated AFSD performance in primary care patients referred for echocardiogram (echo).MethodsThe AFSD has a light indication of irregular rhythm and single-lead ECG recording. Patients were instructed to hold the device for 1 min, and AF indication was recorded. A 12-lead ECG was performed for all AFSD-positive patients and 250 patients with negative AFSD screen. Echos were performed based on a clinical risk score: all high-risk patients and a sampling of low-risk patients underwent complete echo. Intermediate risk patients first had a screening echocardiogram, with a follow-up complete study if abnormality was suspected.ResultsIn 5 days, 1518 patients underwent clinical evaluation and cardiovascular risk stratification: mean age 58±16 years, 66% women. The AFSD was positive in 6.4%: 12.6% high risk, 6.1% intermediate risk and 2.2% low risk. Older age was a risk factor (9.3% vs 4.8% in those more than and less than 65 years, p=0.001). AFSD positive was independently associated with heart disease in echo (OR=3.9, 95% CI 2.1 to 7.2, p<0.001). Compared with 12-lead ECG, the AFSD had sensitivity of 90.2% (95% CI 77.0% to 97.3%) and specificity of 84.0% (95% CI 79.3% to 88.0%) for AF detection.ConclusionAFSD demonstrated high sensitivity for AF detection in primary care patients referred for echo. AF prevalence was substantial and independently associated with structural or functional heart disease, suggesting that AFSD screening could be a useful primary care tool to stratify risk and prioritise echo.

Atrial fibrillation: prevalence in primary care patients in Brazil

2013 ◽  
Vol 46 (4) ◽  
pp. e4
Author(s):  
M.S. Marcolino ◽  
D.M.F. Palhares ◽  
M.B.M. Alkmim ◽  
A.L. Ribeiro
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Primary Care Patients

scholarly journals Atrial fibrillation: prevalence in a large database of primary care patients in Brazil

EP Europace ◽  
2015 ◽  
Vol 17 (12) ◽  
pp. 1787-1790 ◽  
Author(s):  
Milena S. Marcolino ◽  
Daniel M.F. Palhares ◽  
Emelia J. Benjamin ◽  
Antonio L. Ribeiro
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Large Database ◽  
Primary Care Patients

scholarly journals Warfarin treatment and risk of stroke among primary care patients with atrial fibrillation

2016 ◽  
Vol 50 (5-6) ◽  
pp. 311-316 ◽  
Author(s):  
Per Wändell ◽  
Axel C. Carlsson ◽  
Martin J Holzmann ◽  
Johan Ärnlöv ◽  
Sven-Erik Johansson ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Warfarin Treatment ◽  
Primary Care Patients

Stroke risk reassessment and oral anticoagulant initiation in primary care patients with atrial fibrillation: A ten‐year follow‐up

2021 ◽  
Author(s):  
Woldesellassie M. Bezabhe ◽  
Luke R. Bereznicki ◽  
Jan Radford ◽  
Barbara C. Wimmer ◽  
Mohammed S. Salahudeen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Primary Care ◽  
Oral Anticoagulant ◽  
Stroke Risk ◽  
Primary Care Patients
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