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NICE: screen for AF

GPs should opportunistically screen their patients for atrial fibrillation, new NICE guidance recommends.

The draft guidance, which also advises on areas covered by the new QOF including use of ECGs and anticoagulation treatment, was released for consultation this week ahead of its anticipated publication in June.

The guidance advises: 'While general population screening is beyond the scope of this guideline, targeted/opportunistic screening of symptomatic patients or those with risk factors may allow identification of AF patients.'

It adds: 'Many patients with risk factors for developing AF, such as hypertension and diabetes, do attend for regular checkups with their GPs. In these cases there is a possibility of opportunistic case-finding.'

Dr Martin Fotherby, senior lecturer in ageing and stroke medicine at the University of Leicester and a member of the guideline development group, said: 'One area that needs highlighting is the idea of screening opportunistically for atrial fibrillation.

'All patients ­ particularly older patients ­ who are attending for whatever purpose should have their pulse felt. If the pulse is irregular they should have an ECG.'

The development group identified five priority recommendations, including ECGs in all suspected cases of AF and use of a stroke risk stratification algorithm to select anti-coagulant or anti-platelet drugs.

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