Implementation of Atrial Fibrillation Screening Worldwide"”A Narrative Review

Background Atrial fibrillation (AF) screening is being increasingly encouraged due to the increasing burden of AF and its association with stroke, but approaches to screening implementation appear to vary. Objective To synthesise findings from AF screening implementation studies and gain insight into screening approaches, settings, and technology use. Methods We performed a structured search of the MEDLINE database through the PubMed interface from January 2000 to January 2024. The search terms included "atrial fibrillation" and "screening" and their synonyms. Articles that described screening implementation, including screening methods (e.g. observational studies and interventional studies with or without a comparator/control), were included. Editorial, commentary, engineering, and basic science articles were excluded. Results 1,767 abstracts were screened, of which 138 full articles were reviewed, and 87 studies were included. 15 (17.2%) of the studies were randomised control trials or had a comparator group, while the remaining had no comparator. Most (89.7%) of the studies were conducted in high-income countries/ regions in point-of-care settings and remotely, using handheld 1-lead ECG devices, while wearable alternatives are emerging (Table 1). Conclusion AF screening implementation studies were mainly conducted in high-income countries/ regions using mobile single-lead digital technologies in point-of-care settings and remotely. Limited research exists on the comparative effectiveness of varying approaches.