Evidence Gaps and Lessons in the Early Detection of Atrial Fibrillation: A Prospective Study in a Primary Care Setting (PREFATE Study)
<b>Background/Objectives:</b> In Europe, the prevalence of AF is expected to increase 2.5-fold over the next 50 years with a lifetime risk of 1 in 3–5 individuals after the age of 55 years and a 34% rise in AF-related strokes. The PREFATE project investigates evidence gaps in the early d...
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2025-01-01
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| author | Josep L. Clua-Espuny Alba Hernández-Pinilla Delicia Gentille-Lorente Eulàlia Muria-Subirats Teresa Forcadell-Arenas Cinta de Diego-Cabanes Domingo Ribas-Seguí Anna Diaz-Vilarasau Cristina Molins-Rojas Meritxell Palleja-Millan Eva M. Satué-Gracia Francisco Martín-Luján |
| author_facet | Josep L. Clua-Espuny Alba Hernández-Pinilla Delicia Gentille-Lorente Eulàlia Muria-Subirats Teresa Forcadell-Arenas Cinta de Diego-Cabanes Domingo Ribas-Seguí Anna Diaz-Vilarasau Cristina Molins-Rojas Meritxell Palleja-Millan Eva M. Satué-Gracia Francisco Martín-Luján |
| author_sort | Josep L. Clua-Espuny |
| collection | DOAJ |
| description | <b>Background/Objectives:</b> In Europe, the prevalence of AF is expected to increase 2.5-fold over the next 50 years with a lifetime risk of 1 in 3–5 individuals after the age of 55 years and a 34% rise in AF-related strokes. The PREFATE project investigates evidence gaps in the early detection of atrial fibrillation in high-risk populations within primary care. This study aims to estimate the prevalence of device-detected atrial fibrillation (DDAF) and assess the feasibility and impact of systematic screening in routine primary care. <b>Methods:</b> The prospective cohort study (NCT 05772806) included 149 patients aged 65–85 years, identified as high-risk for AF. Participants underwent 14 days of cardiac rhythm monitoring using the Fibricheck<sup>®</sup> app (CE certificate number BE16/819942412), alongside evaluations with standard ECG and transthoracic echocardiography. The primary endpoint was a new AF diagnosis confirmed by ECG or Holter monitoring. Statistical analyses examined relationships between AF and clinical, echocardiographic, and biomarker variables. <b>Results:</b> A total of 18 cases (12.08%) were identified as positive for possible DDAF using FibriCheck<sup>®</sup> and 13 new cases of AF were diagnosed during follow-up, with a 71.4-fold higher probability of confirming AF in FibriCheck<sup>®</sup>-positive individuals than in FibriCheck<sup>®</sup>-negative individuals, resulting in a post-test odds of 87.7%. Significant echocardiographic markers of AF included reduced left atrial strain (<26%) and left atrial ejection fraction (<50%). MVP ECG risk scores ≥ 4 strongly predicted new AF diagnoses. However, inconsistencies in monitoring outcomes and limitations in current guidelines, particularly regarding AF burden, were observed. <b>Conclusions:</b> The study underscores the feasibility and utility of AF screening in primary care but identifies critical gaps in diagnostic criteria, anticoagulation thresholds, and guideline recommendations. |
| format | Article |
| id | doaj-art-15d2353eea8147a68ea747a893c16971 |
| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-15d2353eea8147a68ea747a893c169712025-01-24T13:24:05ZengMDPI AGBiomedicines2227-90592025-01-0113111910.3390/biomedicines13010119Evidence Gaps and Lessons in the Early Detection of Atrial Fibrillation: A Prospective Study in a Primary Care Setting (PREFATE Study)Josep L. Clua-Espuny0Alba Hernández-Pinilla1Delicia Gentille-Lorente2Eulàlia Muria-Subirats3Teresa Forcadell-Arenas4Cinta de Diego-Cabanes5Domingo Ribas-Seguí6Anna Diaz-Vilarasau7Cristina Molins-Rojas8Meritxell Palleja-Millan9Eva M. Satué-Gracia10Francisco Martín-Luján11Ebrictus Research Group, Research Support Unit Terres de l’Ebre, Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), 43500 Tortosa, SpainServicio de Atención Primaria Camp de Tarragona, Institut Català de la Salut, 43761 Tarragona, SpainServicio de Cardiología, Hospital Virgen de la Cinta de Tortosa, Institut Català de la Salut, 43500 Tortosa, SpainPrimary Health-Care Centre Amposta, Institute Català de la Salut, Primary Care Service (SAP) Terres de l’Ebre, 43870 Amposta, SpainPrimary Health-Care Centre Tortosa Oest, Institute Català de la Salut, Primary Care Service (SAP) Terres de l’Ebre, 43500 Tortosa, SpainPrimary Health-Care Centre Salou, Institute Català de la Salut, Department of Primary Care Camp de Tarragona, 43840 Salou, SpainDepartment of Primary Care Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, SpainDepartment of Primary Care Camp de Tarragona, Institut Català de la Salut, 43005 Tarragona, SpainPrimary Health-Care Centre Sant Pere I Sant Pau, Institute Català de la Salut, Department of Primary Care Camp de Tarragona, 43007 Tarragona, SpainUnitat de Suport a la Recerca Camp de Tarragona-Reus, Institut de Recerca en Atenció Primària Jordi Gol, 43201 Reus, SpainUnitat de Suport a la Recerca, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 43201 Reus, SpainUnitat de Suport a la Recerca, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 43201 Reus, Spain<b>Background/Objectives:</b> In Europe, the prevalence of AF is expected to increase 2.5-fold over the next 50 years with a lifetime risk of 1 in 3–5 individuals after the age of 55 years and a 34% rise in AF-related strokes. The PREFATE project investigates evidence gaps in the early detection of atrial fibrillation in high-risk populations within primary care. This study aims to estimate the prevalence of device-detected atrial fibrillation (DDAF) and assess the feasibility and impact of systematic screening in routine primary care. <b>Methods:</b> The prospective cohort study (NCT 05772806) included 149 patients aged 65–85 years, identified as high-risk for AF. Participants underwent 14 days of cardiac rhythm monitoring using the Fibricheck<sup>®</sup> app (CE certificate number BE16/819942412), alongside evaluations with standard ECG and transthoracic echocardiography. The primary endpoint was a new AF diagnosis confirmed by ECG or Holter monitoring. Statistical analyses examined relationships between AF and clinical, echocardiographic, and biomarker variables. <b>Results:</b> A total of 18 cases (12.08%) were identified as positive for possible DDAF using FibriCheck<sup>®</sup> and 13 new cases of AF were diagnosed during follow-up, with a 71.4-fold higher probability of confirming AF in FibriCheck<sup>®</sup>-positive individuals than in FibriCheck<sup>®</sup>-negative individuals, resulting in a post-test odds of 87.7%. Significant echocardiographic markers of AF included reduced left atrial strain (<26%) and left atrial ejection fraction (<50%). MVP ECG risk scores ≥ 4 strongly predicted new AF diagnoses. However, inconsistencies in monitoring outcomes and limitations in current guidelines, particularly regarding AF burden, were observed. <b>Conclusions:</b> The study underscores the feasibility and utility of AF screening in primary care but identifies critical gaps in diagnostic criteria, anticoagulation thresholds, and guideline recommendations.https://www.mdpi.com/2227-9059/13/1/119arrhythmiasatrial fibrillationcardiac/diagnosisheart rate determinationechocardiography/statistics and numerical dataelectrocardiography |
| spellingShingle | Josep L. Clua-Espuny Alba Hernández-Pinilla Delicia Gentille-Lorente Eulàlia Muria-Subirats Teresa Forcadell-Arenas Cinta de Diego-Cabanes Domingo Ribas-Seguí Anna Diaz-Vilarasau Cristina Molins-Rojas Meritxell Palleja-Millan Eva M. Satué-Gracia Francisco Martín-Luján Evidence Gaps and Lessons in the Early Detection of Atrial Fibrillation: A Prospective Study in a Primary Care Setting (PREFATE Study) Biomedicines arrhythmias atrial fibrillation cardiac/diagnosis heart rate determination echocardiography/statistics and numerical data electrocardiography |
| title | Evidence Gaps and Lessons in the Early Detection of Atrial Fibrillation: A Prospective Study in a Primary Care Setting (PREFATE Study) |
| title_full | Evidence Gaps and Lessons in the Early Detection of Atrial Fibrillation: A Prospective Study in a Primary Care Setting (PREFATE Study) |
| title_fullStr | Evidence Gaps and Lessons in the Early Detection of Atrial Fibrillation: A Prospective Study in a Primary Care Setting (PREFATE Study) |
| title_full_unstemmed | Evidence Gaps and Lessons in the Early Detection of Atrial Fibrillation: A Prospective Study in a Primary Care Setting (PREFATE Study) |
| title_short | Evidence Gaps and Lessons in the Early Detection of Atrial Fibrillation: A Prospective Study in a Primary Care Setting (PREFATE Study) |
| title_sort | evidence gaps and lessons in the early detection of atrial fibrillation a prospective study in a primary care setting prefate study |
| topic | arrhythmias atrial fibrillation cardiac/diagnosis heart rate determination echocardiography/statistics and numerical data electrocardiography |
| url | https://www.mdpi.com/2227-9059/13/1/119 |
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