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  • 1 April 2018 to 31 March 2019
  • Project No: 410
  • Funding round: FR 16

Atrial fibrillation (AF) is a condition where the heart has an irregular beat. It may not cause symptoms, occurs in up to 10% of people over 65 years old, and can be detected using a simple hand-held electrocardiograph (ECG) device. AF greatly increases risk of stroke, but there is treatment that inhibits blood clotting (an anticoagulant), and reduces the risk of stroke. About 10% of strokes occur in people unaware that they have AF. Some people have AF all the time, for others it comes and goes (‘paroxysmal AF’). Screening for paroxysmal AF enables people who are unaware that they have AF to be identified and treated. We aim to inform how screening for paroxysmal AF might be carried out and to investigate possible harms associated with screening and how to measure them in order to inform planned research and possible implementation in the NHS.

The questions we want to ask are:

1. How long and how often should people be screened to see if they do have paroxysmal AF?

2. What is practice experience of AF screening

3. How best to measure the psychological effects on patients of screening for AF?

We will screen 1,200 people aged ≥65 not taking anticoagulation from six general practices. Each participant will be offered one month of screening using the hand held device, and asked to record an ECG four times a day, and whenever they have symptoms. We will interview practice staff to understand what they think about the screening process. We will conduct focus groups and individual interviews with patients before, soon after and several months after they have been invited for screening to identify potential concerns. We will adapt and test a questionnaire which measures any psychological effects of the screening.