P6543Screen-detected atrial fibrillation in a one-minute single-lead ECG predicts mortality in elderly subjects

Abstract Background Atrial fibrillation (AF) is the most common arrhythmia associated with increased morbidity and mortality. Current guidelines recommend opportunistic screening for AF but the prognostic impact of screen-detected AF is unclear. Methods We performed a 4-week, prospective, pharmacy-based AF screening study in 7107 elderly citizens (≥65 years) using a hand-held, automated, one-minute single-lead ECG (SL-ECG) recording device. Prevalence and incidence of AF was assessed, and data on all-cause death and hospitalization for cardiovascular (CV) causes were collected over a median follow-up of 401 (372; 435) days. Results Automated SL-ECG analyses revealed heartbeat irregularities suspicious of AF in 432 (6.1%) participants with newly diagnosed AF in 3.6% of all subjects. During follow-up, 62 participants (0.9%) died and 390 (6.0%) were hospitalised for CV causes. Total mortality was 2.3% in participants with a SL-ECG suspicious of AF and 0.8% in subjects with a normal SL-ECG (HR 2.93; 95% CI: 1.49, 5.77; P=0.002, Figure 1A); hospitalization for CV causes occurred in 10.6% and 5.5%, respectively (HR 2.08; 95% CI: 1.52, 2.84; P