Project Title

Screening for atrial fibrillation: A study of adverse effects including bleeding events, quality-of-life aspects and health economic consequences

Background

Screening for atrial fibrillation has gained momentum to improve health and prevent stroke. However, aside from any positive impact on health, continuous screening for atrial fibrillation may cause harm. Currently, the impact of screening on the risk of anticoagulation-mediated bleeding, screening-related anxiety, and healthcare utilization and costs are largely unknown.

Aim

This PhD project investigates: 

1. The risk of major bleeding after screening for atrial fibrillation and anticoagulant treatment upon detection compared to no screening 

2. Quality of life changes during and after screening, and examine associations with diagnoses of atrial fibrillation, stroke, and major bleeding 

3. Hospitalizations, procedures, complications, and economic implications associated with atrial fibrillation screening and treatment

Methods

We will analyse unexplored data from 6,004 trial participants with stroke risk factors, who were randomised to usual care (n=4,503) or continuous heart rhythm screening with anticoagulant treatment upon detection of atrial fibrillation (n=1,501). Next, we want to validate our results by matching a control cohort using the National Danish Patient Registry.

Preliminary results

In our recently published study, we found the risk of major bleeding after anticoagulant treatment was not higher in those screened for atrial fibrillation than in the controls, even though the detection of atrial fibrillation was threefold higher in the screened group compared to the control group. Our next studies are underway, casting light on quality of life during and after systematic and long-term screening for atrial fibrillation.