This site is intended for health professionals only

At the heart of general practice since 1960

pul jul aug2020 cover 80x101px
Read the latest issue online

Independents' Day

Pressure put on Government to make GPs screen for atrial fibrillation

Cardiovascular experts, along with UK MPs, are mounting a new push to overturn the UK National Screening Committee’s decision to rule out a GP screening programme for atrial fibrillation (AF).

Last year Pulse revealed that GP practices could be offered incentives through QOF to screen elderly people for atrial fibrillation, under new NICE plans, but the initiative found opposition from GP leaders.

The move comes as international collaboration AF-Screen, comprising over 130 cardiologists, neurologists, GPs, health economists, nurses, pharmacists and patient support organisations from 33 countries, is leading, a global drive to introduce national screening programs for atrial fibrillation.

A white paper, just published in the Journal of the American Heart Association, Circulation, calls for governments worldwide to introduce screening for atrial fibrillation in all people aged 65 years and over in a bid to cut the risk of stroke and death.

In the UK, the Arrhythmia Alliance, together with partner organisation AF Association, and the All Party Parliamentary Group on atrial fibrillation, are lobbying the UK National Screening Committee to reconsider its decision from 2014.

The Committee dismissed the notion of a systemic GP screening programme as it remained unconvinced that it was beneficial.

Trudie Lobban, chief executive and founder Arrhythmia Alliance, and a member of the AF-Screen collaboration, said: ‘In the UK, we know that there are over half a million people with undiagnosed AF, who are at risk of suffering a debilitating, life-threatening AF-related stroke.’

She added: ‘We welcome the publication of this important white paper which confirms the unquestionable value of a national screening programme for AF in people aged 65 and over.’

Professor Richard Schilling, medical director of the Atrial Fibrillation Association, said: ‘Widespread screening for asymptomatic atrial fibrillation in people aged 65 years and above could cost-effectively reduce strokes and their associated disability, and help save lives.

'However, this is not yet widely recommended in guidelines.’

But GP leaders have argued that screening for atrial fibrillation went against National Screening Committee advice.

Dr Peter Swinyard, chair of the Family Doctor Association, questioned the efficacy of a full-scale screening programme, describing it as another ‘box-ticking’ exercise.

The National Screening Committee review in 2014 found that it was ‘not clear that those identified as at risk through screening would benefit from early diagnosis’.

The evidence review also highlighted concerns over the available test and the quality of current treatment pathways for atrial fibrillation. The next review is expected in 2017/18.

The white paper, Screening for Atrial Fibrillation, A Report of the AF-SCREEN International Collaboration, has 60 contributing authors and was published in Circulation (9 May 2017 issue 19; Vol 135).

Readers' comments (3)

  • When I audited AF treatment - it was the old AF that a decision not to use Warfarin was the biggest issue by far - new cases were
    all being actively treated.
    This backlog effect is the issue that is not being addressed.
    We also noticed a number of strokes/TIA were in AF at presentation who we knew were in SR within the last year. From this latter observation, I wonder if there is a limit to how far we can go to prevent AF driven strokes as the events may happen quickly after the onset of new AF.

    Unsuitable or offensive? Report this comment

  • Can someone tell me that there is no pharma funding of AF-Screen International collaboration or Arrhythmia Alliance??
    I bet they can't!
    This is why the marketing budget is always MUCH larger than the R&D budget!

    Unsuitable or offensive? Report this comment

  • Screening for AF is an important health measure. Under QOF, I trained the receptionist to take a radial pulse rhythm. If irregular, the practice used an event monitor, to see whether in sinus rhythm or not. Fairly instant diagnosis!

    My mother died of a massive stroke having AF ( and anti coagulated!). I was found by chance ( h/o palpitations), to have paroxysmal AF followed by prolonged asystole- now have a PM.

    Undetected AF is a considerable health morbidity/mortality burden. It is easily detected, and there is treatment available. Screening is good health care.

    Unsuitable or offensive? Report this comment

Have your say