Better prevention of stroke through screening for atrial fibrillation

摘要

As Western populations age, the prevalence of atrial fibrillation is on the rise. In the UK, there are over three-quarters of a million people with atrial fibrillation, and more than 10% of people over 75 years of age have this most common arrhythmia.1 The most serious consequence of the arrhythmia is cardioembolic stroke. About 20% of ischaemic strokes are cardioembolic, the great majority in relation to atrial fibrillation, with over 20 000 such strokes in the UK every year. Stroke associated with atrial fibrillation tends to be more severe, and to result in more complications and a greater risk of death or institutionalisation. A person aged over 75 years with a middle cerebral artery occlusion — for which cardioembolism is the most frequent cause — has a greater than 95% likelihood of death or institutionalisation, with all the attendant health and social care costs.2 In every respect it is the most ‘expensive’ form of stroke.