General practitioners' perceptions on opportunistic single-time point screening for atrial fibrillation: A European quantitative survey.

Background

There is no clear guidance on how to implement opportunistic atrial fibrillation (AF) screening in daily clinical practice.

Objectives

This study evaluated the perception of general practitioners (GPs) about value and practicalities of implementing screening for AF, focusing on opportunistic single-time point screening with a single-lead electrocardiogram (ECG) device.

Methods

A descriptive cross-sectional study was conducted with a survey developed to assess overall perception concerning AF screening, feasibility of opportunistic single-lead ECG screening and implementation requirements and barriers.

Results

A total of 659 responses were collected (36.1% Eastern, 33.4% Western, 12.1% Southern, 10.0% Northern Europe, 8.3% United Kingdom & Ireland). The perceived need for standardized AF screening was rated as 82.7 on a scale from 0 to 100. The vast majority (88.0%) indicated no AF screening program is established in their region. Three out of four GPs (72.1%, lowest in Eastern and Southern Europe) were equipped with a 12-lead ECG, while a single-lead ECG was less common (10.8%, highest in United Kingdom & Ireland). Three in five GPs (59.3%) feel confident ruling out AF on a single-lead ECG strip. Assistance through more education (28.7%) and a tele-healthcare service offering advice on ambiguous tracings (25.2%) would be helpful. Preferred strategies to overcome barriers like insufficient (qualified) staff, included integrating AF screening with other healthcare programs (24.9%) and algorithms to identify patients most suitable for AF screening (24.3%).

Conclusion

GPs perceive a strong need for a standardized AF screening approach. Additional resources may be required to have it widely adopted into clinical practice.

Informations de copyright

Copyright © 2023 Vermunicht, Grecu, Deharo, Buckley, Palà, Mairesse, Farkowski, Bergonti, Pürerfellner, Hanson, Neubeck, Freedman, Witt, Hills, Lund, Giskes, Engler, Schnabel, Heidbuchel, Desteghe and for the AFFECT-EU investigators.

Déclaration de conflit d'intérêts

BF has received grants to the institution for investigator-initiated studies from the BMS-Pfizer Alliance, personal fees and nonfinancial support from BMS-Pfizer Alliance and Pfizer, and loan devices from AliveCor. HH did receive personal lecture and consultancy fees from Abbott, Biotronik, Daiichi-Sankyo, Pfizer-BMS, Medscape, and Springer Healthcare Ltd. He received unconditional research grants through the University of Antwerp and/or the University of Hasselt from Abbott, Bayer, Biotronik, Biosense-Webster, Boston-Scientific, Boehringer-Ingelheim, Daicchi-Sankyo, Fibricheck/Qompium, Medtronic, and Pfizer-BMS. HP received speaker fees from Bayer, Pfizer, Boehringer Ingelheim and Daiichi-Sankyo. LN and CH hold an investigator initiated grant from Daiichi Sankyo (£75,000). MF received speaker fees from Pfizer Poland and Boehringer Ingelheim Poland. RS has received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation program under the grant agreement No 648131, from the European Union’s Horizon 2020 research and innovation program under the grant agreement No 847770 (AFFECT-EU) and German Center for Cardiovascular Research (DZHK e.V.) (81Z1710103 and 81Z0710114); German Ministry of Research and Education (BMBF 01ZX1408A) and ERACoSysMed3 (031L0239). RS has received lecture fees and advisory board fees from BMS/Pfizer outside this work. HW was employed by Pfizer Pharma GmbH, Berlin, Germany. MH was employed by StopAfib.org, Dallas, TX, United States. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.