Research Priorities in Atrial Fibrillation Screening
Emelia J. Benjamin, Alan S. Go, Patrice Desvigne‐Nickens, Christopher D. Anderson, Barbara Casadei, Lin Y. Chen, Harry J.G.M. Crijns, Ben Freedman, Mellanie True Hills, Jeff S. Healey, Hooman Kamel, Dong‐Yun Kim, Mark S. Link, Renato D. Lópes, Steven A. Lubitz, David D. McManus, Peter A. Noseworthy, Marco Pérez, Jonathan P. Piccini, Renate B. Schnabel, Daniel E. Singer, Robert G Tieleman, Mintu P. Turakhia, Isabelle C. Van Gelder, Lawton S. Cooper, Sana M. Al‐Khatib
Abstract
Clinically recognized atrial fibrillation (AF) is associated with higher risk of complications, including ischemic stroke, cognitive decline, heart failure, myocardial infarction, and death. It is increasingly recognized that AF frequently is undetected until complications such as stroke or heart failure occur. Hence, the public and clinicians have an intense interest in detecting AF earlier. However, the most appropriate strategies to detect undiagnosed AF (sometimes referred to as subclinical AF) and the prognostic and therapeutic implications of AF detected by screening are uncertain. Our report summarizes the National Heart, Lung, and Blood Institute's virtual workshop focused on identifying key research priorities related to AF screening. Global experts reviewed major knowledge gaps and identified critical research priorities in the following areas: (1) role of opportunistic screening; (2) AF as a risk factor, risk marker, or both; (3) relationship between AF burden detected with long-term monitoring and outcomes/treatments; (4) designs of potential randomized trials of systematic AF screening with clinically relevant outcomes; and (5) role of AF screening after ischemic stroke. Our report aims to inform and catalyze AF screening research that will advance innovative, resource-efficient, and clinically relevant studies in diverse populations to improve the diagnosis, management, and prognosis of patients with undiagnosed AF.