Skip to main content

Main menu

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • RESOURCES
    • About BJGP
    • Conference
      • Programme
    • Advertising
    • BJGP Blog
    • eLetters
    • Feedback
    • Librarian information
    • Alerts
    • Resilience
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
    • RCGP e-Portfolio

User menu

  • Subscriptions
  • Alerts
  • Log in

Search

  • Advanced search
British Journal of General Practice
  • RCGP
    • BJGP for RCGP members
    • BJGP Open
    • RCGP eLearning
    • InnovAIT Journal
    • Jobs and careers
    • RCGP e-Portfolio
  • Subscriptions
  • Alerts
  • Log in
  • Follow bjgp on Twitter
  • Visit bjgp on Facebook
  • Blog
British Journal of General Practice

Advanced Search

  • HOME
  • ONLINE FIRST
  • CURRENT ISSUE
  • ALL ISSUES
  • AUTHORS & REVIEWERS
  • SUBSCRIBE
  • RESOURCES
    • About BJGP
    • Conference
    • Advertising
    • BJGP Blog
    • eLetters
    • Feedback
    • Librarian information
    • Alerts
    • Resilience
Editorials

Atrial fibrillation: time for active case finding

John Robson and Richard Schilling
Br J Gen Pract 2019; 69 (679): 58-59. DOI: https://doi.org/10.3399/bjgp19X700985
John Robson
Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Richard Schilling
Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London.
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Info
  • eLetters
  • PDF
Loading

Substantial evidence has now accrued to robustly support systematic case finding using pulse regularity checks in general practice to detect atrial fibrillation (AF) in people aged ≥65 years. Fay et al have summarised this evidence to make the case to detect an additional 10–15 cases of AF per 1000 people screened.1 Cole et al have shown that such ascertainment in people aged ≥65 years by GPs is feasible in entire local CCG populations, with increases in AF register size of 5–10%.2

However, the National Screening Committee has so far remained doubtful about supporting a national screening programme for AF, and the US Preventive Services Task Force recently recommended against electrocardiographic screening for AF.3 An increasing number of methods to detect irregularity of heart beat — ranging from simple pulse checks every 5 years in primary care to continuous electronic monitoring detecting short-duration irregularities with less certain treatment benefits — have complicated the picture.4 Case finding in general practice using episodic pulse regularity checks is supported by a UK Health Technology Report concluding that: ‘Systematic opportunistic screening is more likely to be cost-effective than systematic population screening. Nurse pulse palpation or modified blood pressure monitors would be appropriate screening tests, with confirmation by diagnostic 12-lead electrocardiography.’ 5

Current NICE guidance on the measurement of blood pressure also recommends pulse palpation to detect irregularity. However, despite the positive and cost-effective results of case finding shown in the randomised SAFE trial and observational studies in UK general practice,2,6 some GPs and other commentators have remained doubtful about such simple methods for the systematic detection of AF.7 Large randomised controlled trials are the desirable gold standard for new cost-effective interventions for …

View Full Text

  RCGP login

Members, please Login at RCGP to access the journal online.

  Subscriber login

Enter your BJGP login information below.

Log in using your username and password

Enter your British Journal of General Practice username.
Enter the password that accompanies your username.
Forgot your user name or password?

Log in through your institution

You may be able to gain access using your login credentials for your institution. Contact your library if you do not have a username and password.
If your organization uses OpenAthens, you can log in using your OpenAthens username and password. To check if your institution is supported, please see this list. Contact your library for more details.

Pay Per Article - You may access this article (from the computer you are currently using) for 1 day for US$35.00

Regain Access - You can regain access to a recent Pay per Article purchase if your access period has not yet expired.

  Subscribe

Subscribe to the Journal - Subscribe to the print and/or online journal.

Back to top
Previous ArticleNext Article

In this issue

British Journal of General Practice: 69 (679)
Br J Gen Pract
Vol. 69, Issue 679
February 2019
  • Table of Contents
  • Index by author
Download PDF
Download PowerPoint
Article Alerts
Or,
sign in or create an account with your email address
Email Article

Thank you for recommending British Journal of General Practice.

NOTE: We only request your email address so that the person to whom you are recommending the page knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Atrial fibrillation: time for active case finding
(Your Name) has forwarded a page to you from British Journal of General Practice
(Your Name) thought you would like to see this page from British Journal of General Practice.
Citation Tools
Atrial fibrillation: time for active case finding
John Robson, Richard Schilling
Br J Gen Pract 2019; 69 (679): 58-59. DOI: 10.3399/bjgp19X700985

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero

Share
Atrial fibrillation: time for active case finding
John Robson, Richard Schilling
Br J Gen Pract 2019; 69 (679): 58-59. DOI: 10.3399/bjgp19X700985
del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One
  • Mendeley logo Mendeley

Jump to section

  • Top
  • Article
    • ASYMPTOMATIC PRESENTATION OF AF
    • ROUTINE PULSE CHECKS CASE FINDING AND/OR SCREENING FOR AF
    • ANTICOAGULATION OF ASYMPTOMATIC AF AND STROKE RISK
    • CONCLUSION
    • Notes
    • REFERENCES
  • Figures & Data
  • Info
  • eLetters
  • PDF

More in this TOC Section

  • GPs online: turning expectations into reality with the new NHS app
  • Medical leadership and general practice: seductive or dictatorial?
  • Faecal immunochemical testing in general practice
Show more Editorials

Related Articles

Cited By...

 

Influenza in the elderly

BJGP Open

 

@BJGPjournal's Likes on Twitter

 
 

British Journal of General Practice

NAVIGATE

  • Home
  • Current Issue
  • All Issues
  • Online First
  • Authors & reviewers

RCGP

  • BJGP for RCGP members
  • BJGP Open
  • RCGP eLearning
  • InnovAiT Journal
  • Jobs and careers
  • RCGP e-Portfolio

MY ACCOUNT

  • RCGP members' login
  • Subscriber login
  • Activate subscription
  • Terms and conditions

NEWS AND UPDATES

  • About BJGP
  • Alerts
  • RSS feeds
  • Facebook
  • Twitter

AUTHORS & REVIEWERS

  • Submit an article
  • Writing for BJGP: research
  • Writing for BJGP: other sections
  • BJGP editorial process & policies
  • BJGP ethical guidelines
  • Peer review for BJGP

CUSTOMER SERVICES

  • Advertising
  • Contact subscription agent
  • Copyright
  • Librarian information

CONTRIBUTE

  • BJGP Blog
  • eLetters
  • Feedback

CONTACT US

BJGP Journal Office
RCGP
30 Euston Square
London NW1 2FB
Tel: +44(0) 20 3188 7400
Email: journal@rcgp.org.uk

British Journal of General Practice is an editorially-independent publication of the Royal College of General Practitioners
© 2019 British Journal of General Practice

Print ISSN: 0960-1643
Online ISSN: 1478-5242