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  • Erica S. Zado
    Address reprint requests and correspondence: Ms Erica S. Zado, Section of Cardiac Electrophysiology, Cardiovascular Division,Hospital of the University of Pennsylvania, Founders 9, 3400 Spruce St, Philadelphia, PA 19104.
    Section of Cardiac Electrophysiology, Cardiovascular Division, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
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      SCREEN-AF is a large, multinational, randomized trial in which Gladstone et al (JAMA Cardiol February 24, 2021; doi:10.1001/jamacardio.2021.0038, PMID 33625468) sought to assess 2 home-based atrial fibrillation (AF) screening methods. All patients were 75 years or older, had hypertension, had no known history of AF, and had no contraindications to oral anticoagulation (OAC). Main exclusions included a history of AF or atrial flutter, currently on OAC for another reason, and presence of a cardiac implantable device such as pacemaker. Patients were randomized 1:1 to control or screening groups. The control group received standard care including pulse check and auscultation for AF by a physician at baseline and 6 months. The study group wore a 2-week continuous electrocardiographic (cECG) patch monitor at baseline and at 3 months in addition to the office visits at baseline and 6 months as part of standard care. The monitor results were sent to the patient’s primary care physician who was responsible for any treatment decisions. The study group participants were also provided with a home blood pressure (BP) monitor that has an AF detection algorithm to use twice daily during the monitoring periods. The primary outcome was AF episodes lasting >5 minutes within the 6-month study period. Secondary outcomes included OAC use, monitor compliance and tolerability, and performance of the BP monitor for AF screening.
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