Experts Recommend Atrial Fibrillation Screenings for Senior Citizens to Reduce Risk of Stroke and Death

May 26, 2017 10:16 AM

Hackensack Meridian Health Hackensack University Medical Center electrophysiologist, along with members of AF-SCREEN contribute to new research published in American Heart Association's journal Circulation

Screening for asymptomatic atrial fibrillation (AF) in people aged 65 and over and treating it with anticoagulant medications could prevent many thousands of strokes worldwide each year, according to a top-level panel of experts in today's issue of Circulation, the journal of the American Heart Association. The white paper was written by 60 AF-SCREEN members including Taya Glotzer, M.D., director of Cardiac Electrophysiology Research at Hackensack Meridian Health Hackensack University Medical Center.

An international collaboration, AF-SCREEN, is behind a global push to introduce national screening programs for the common heart condition atrial fibrillation (AF), which triggers catastrophic strokes. AF-SCREEN is comprised of over 130 cardiologists, neurologists, general practitioners, health economists, nurses, pharmacists and patient support organizations from 33 countries.

"Strokes from AF are larger, more severe and harder to survive than other strokes," said Taya Glotzer, M.D., FACC, FHRS, clinical associate professor of medicine at Rutgers New Jersey Medical School and director of Cardiac Electrophysiology Research at Hackensack University Medical Center. "Protecting vulnerable people from ever experiencing one will spare patients and their families a lot of heartache."

AF is a common and serious heart arrhythmia accounting for one in three strokes. This occurs because the abnormal heart rhythm poses the risk of blood clots forming inside of the heart. When clots break off they will usually travel to the brain, causing severe strokes. Approximately 10 percent of ischemic strokes are caused by AF that is first detected at the time of stroke. Asymptomatic AF, which underlies these strokes, is not uncommon and can easily be detected by simply taking the pulse, or by handheld ECGs which provide a diagnosis in less than a minute.

"Widespread screening for asymptomatic AF in seniors could reduce the risk of strokes and help save lives," continued Dr. Glotzer. "While not yet widely recommended in guidelines, there is good evidence that finding asymptomatic AF before symptoms develop and treating it with oral anticoagulants and other therapies could greatly reduce the increased risk of stroke and partially reverse the increased risk of associated death." 

Screenings have been shown to detect undiagnosed AF in 1 percent to 3 percent of people ages 65 to 75 years old. Given how easy it is to detect AF, and given the poor outcomes that can be substantially improved with treatment, the AF-SCREEN group believes there is a reasonable, cost-effective case to screen for this abnormal heart rhythm in seniors.

The white paper calls for governments worldwide to introduce screening for all senior citizens, age 65 or older. Experts suggest running screening programs through general practitioners, pharmacies, or even in the community. In addition, experts suggest carrying out the program with pulse checking, a blood pressure monitor, or, whenever possible, a handheld electrocardiogram (ECG) device, which is the most effective medical tool that can provide the most accurate AF diagnosis.

"Dr. Glotzer's research with AF-SCREEN International Collaboration provides the healthcare community with critical recommendations that will promote healthier families and communities around the world," said Joseph E. Parrillo, M.D., chair, Heart and Vascular Hospital at Hackensack University Medical Center. "Providing preventative health services such as screenings for asymptomatic AF to our patients allows us to take a proactive approach in delivering high-quality care and save lives."

Individuals with concerns about their heartbeat and stroke risk can take immediate action by visiting their doctor. "If you are 65 years or older, then you can see your doctor to check your pulse, and perhaps request that a rhythm strip of your heart's rhythm be obtained," said Dr. Glotzer.

Statistics from the World Heart Federation show 15 million people have a stroke each year, nearly six million die, and another five million are left permanently disabled. The Adult Cardiology & Heart Surgery programs at Hackensack Meridian Health Hackensack University Medical Center are ranked within the top 50 hospitals in the United States by U.S. News & World Report.

Fast Facts on Atrial fibrillation, screening and treatment:

  • Atrial fibrillation (AF) is responsible for one third of all strokes.
  • 27 per cent of AF-related strokes (amounting to 10% of all strokes) aren't detected prior to stroke because AF is often asymptomatic (no symptoms and unrecognized by the person with AF)
  • AF-related strokes are more severe and cause greater disability than non-AF strokes
  • Widespread screening for asymptomatic AF among people aged 65 years and over would be a potent way to prevent strokes and the burden of stroke-related harm because AF-related strokes are largely preventable by treatment with oral anticoagulant drugs.
  • It is time to include AF screening in more national and continental guidelines worldwide.

For additional information about the AF-SCREEN International Collaboration, visit www.afscreen.org.

The White Paper, Screening for Atrial Fibrillation, A Report of the AF-SCREEN International Collaboration can be found here.
Circulation May 9th 2017 issue 19; Vol 135: 1851-1867.

ABOUT HACKENSACK MERIDIAN HEALTH
Hackensack Meridian Health is a leading not-for-profit health care organization that is the most comprehensive and truly integrated health care network in New Jersey, offering a complete range of medical services, innovative research and life-enhancing care. Hackensack Meridian Health comprises 13 hospitals, including two academic medical centers, two children's hospitals and nine community hospitals, physician practices, more than 120 ambulatory care centers, surgery centers, home health services, long-term care and assisted living communities, ambulance services, lifesaving air medical transportation, fitness and wellness centers, rehabilitation centers, and urgent care and after-hours centers. Hackensack Meridian Health has 28,000 team members, more than 6,000 physicians and is a distinguished leader in health care philanthropy, committed to the health and well-being of the communities it serves.

The Network's notable distinctions include having one of only five major academic medical centers in the nation to receive Healthgrades America's 50 Best Hospitals Award for five or more consecutive years, the number one hospital in New Jersey as ranked by U.S. News and World Report, consistently achieving Magnet® recognition for nursing excellence from the American Nurses Credentialing Center, recipient of the John M. Eisenberg Award for Patient Safety and Quality from The Joint Commission and the National Quality Forum, a six-time recipient of Fortune's "100 Best Companies to Work For," one of the "20 Best Workplaces in Health Care" in the nation, and the number one "Best Place to Work for Women." Hackensack Meridian Health is a member of AllSpire Health Partners, an interstate consortium of leading health systems, to focus on the sharing of best practices in clinical care and achieving efficiencies.

The hospitals of Hackensack Meridian Health include: academic medical centers – Hackensack University Medical Center in Hackensack, Jersey Shore University Medical Center in Neptune; children's hospitals – Joseph M. Sanzari Children's Hospital in Hackensack, K. Hovnanian Children's Hospital in Neptune; community hospitals – Ocean Medical Center in Brick, Riverview Medical Center in Red Bank, Mountainside Medical Center in Montclair, Palisades Medical Center in North Bergen, Raritan Bay Medical Center in Perth Amboy, Southern Ocean Medical Center in Manahawkin, Bayshore Medical Center in Holmdel, Raritan Bay Medical Center in Old Bridge, and Pascack Valley Medical Center in Westwood.

For additional information, please visit www.HackensackMeridianHealth.org.

 

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