ArticleHeart (British Cardiac Society)2022
Refined atrial fibrillation screening and cost-effectiveness in the German population.
Article in Heart (British Cardiac Society), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 12 citations in OpenAlex.
- Health Economic Research Assessing the Value of Early Detection of Cardiovascular Disease: A Systematic Review.PharmacoEconomics · 2023Pooled it
- Cost-effectiveness of atrial fibrillation screening programmes across European nations.European heart journal. Quality of care & clinical outcomes · 2026Article
- Health economic evaluation of left atrial appendage closure in patients with atrial fibrillation and at high risk for stroke and bleeding: a study protocol.Frontiers in health services · 2026Article
- State of the art of mobile health technologies use in clinical arrhythmia care.Communications medicine · 2024Review
- The budget impact of implementing atrial fibrillation-screening in European countries.European heart journal supplements : journal of the European Society of Cardiology · 2024Article
- A Simplified Risk Score to Predict In-Hospital Newly-Diagnosed Atrial Fibrillation in Acute Ischemic Stroke Patients.International journal of general medicine · 2023Article
- Personal recording devices for arrhythmia detection.The British journal of cardiology · 2023Article
- Artificial intelligence for the detection, prediction, and management of atrial fibrillation.Herzschrittmachertherapie & Elektrophysiologie · 2022Review
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Authors and funding
14 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveLittle is known on optimal screening population for detecting new atrial fibrillation (AF) in the community. We describe characteristics and estimate cost-effectiveness for a single timepoint electrocardiographic screening.
methodsWe performed a 12-lead ECG in the German population-based Gutenberg Health Study between 2007 and 2012 (n=15 010), mean age 55±11 years, 51% men and collected more than 120 clinical and biomarker variables, including N-terminal pro B-type natriuretic peptide (Nt-proBNP), risk factors, disease symptoms and echocardiographic variables.
resultsOf 15 010 individuals, 466 (3.1%) had AF. New AF was found in 32 individuals, 0.2% of the total sample, 0.5% of individuals aged 65-74 years and predominantly men (86%). The classical risk factor burden was high in individuals with new AF. The median estimated stroke risk was 2.2%/year, while risk of developing heart failure was 21% over 10 years. In the 65-74 year age group, the cost per quality-adjusted life-year gained resulting from a single timepoint screening was €30 361. In simulations, the costs were highly sensitive to AF detection rates, proportion of treatment and type of oral anticoagulant. Prescreening by Nt-proBNP measurements was not cost-effective in the current setting.
conclusionsIn our middle-aged population cohort, we identified 0.2% new AF by single timepoint screening. There was a significant estimated risk of stroke and heart failure in these individuals. Cost-effectiveness for screening may be reached in individuals aged 65 years and older. The simple age cut-off is not improved by using Nt-proBNP as a biomarker to guide a screening programme.
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