The need to improve
AF detection is paramount
The global burden of cardiac arrhythmias is huge. Patients with atrial fibrillation (AF) face an increased risk for stroke, dementia, heart failure and death¹. Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice and is a global epidemic with an estimated worldwide prevalence in 2010 of almost 34 million people². The condition is expected to more than double over the next 35 years³, which underscores the huge burden of AF and the need for newer, more effective ways to improve its detection and treatment.
Many patients affected by AF are asymptomatic or experience brief episodes that could be wrongly attributed to other conditions. Individuals with AF that go unrecognised and so untreated are at an increased risk for stroke and overall mortality³. Holter monitors that typically monitor patients for 24-48 hours run the risk of not capturing AF in a significant proportion of your presenting patients.
Stroke is the second leading cause of disability in Europe and is the sixth leading cause worldwide4. Women have a higher lifetime risk of stroke than men: about one in five women and one in six men will suffer a stroke in their lifetime4,5. The number of stroke events in Europe is projected to rise from 1.1 million in 2000 to 1.5 million per year by 2025, largely due to the ageing populations6. In the EU, it is estimated that the annual economic cost of stroke is an estimated €27 billion, with an additional €11.1 billion related to informal patient care7. People with AF have a five times greater chance of having a stroke and up to 30% of all strokes result directly from AF8.
Supporting Zensor™ Device
The Zensor™ device has been used to date in hundreds of patients in Europe and the US. At Tallaght University Hospital, Dublin, Ireland, a study was undertaken to identify high risk patients with AF. The device was proven to deliver a convenient and reliable method of diagnosing AF in a high risk population.
Dr Robert Kelly, Consultant Cardiologist and Dr Rónán Collins, Consultant Geriatrician and National Clinical Lead on Stroke, designed and executed a screening study to confirm the efficacy of screening patients with pre-existing associated risk factors using a number of criteria from the Wilson-Junger Criteria9 as set out in the WHO screening programme*.
- 320 patients were screened
- Patient population were
- >60 years with two risk factors (heart failure, diabetes, hypertension)
- >75 years with one risk factor (heart failure, diabetes or hypertension)
- No history of AF or Transient Ischemic Attacks or Stroke
- 14% detection rate (against expected 8%) of AF in high risk patients including those with diabetes, high blood pressure or congestive heart failure
Using Zensor™ device in this targeted screening approach produces a Number Needed to Screen (NSS) of seven patients to identify one with AF.
*Community-based screening for the detection of Atrial Fibrillation in potentially high prevalence cohorts study at Tallaght University Hospital, Dublin, Ireland designed and lead by Dr Rónán Collins, National Stroke Lead, Ireland and Dr Robert Kelly, Consultant Cardiologist.
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2. Barnett Adam S, Lewis William R. Quality of Evidence Underlying the American Heart Association/American College of Cardiology/Heart Rhythm Society Guidelines on the Management of Atrial Fibrillation.JAMA Cardiol, 2017 Mar 01;2 (3):319-323.
3. January Craig T,Wann L Samuel AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation, 2014 Dec 02:130 (23):e199-267.
4.The Top Ten Causes of Death- Fact Sheet No. 310. Geneva,World Health Organization, 2011.
5 Seshadri S et aL The lifetime risk of stroke: estimates from the Framingham Study. Stroke, 2006, 37:345-350.
6. Truelsen T, Piechowski-Jozwiak B, Bonita R. Stroke incidence and prevalence in Europe: a review of available data. European Journal of Neurology, 2006, 13: 581-598.
7. British Geriatrics Society. Human and economic burden of stroke. Age and Ageing, 2009, 38: 4- 5.
8. Marini, C et aL Contribution of atrial fibrillation to incidence and prevalence of atrial fibrillation in the US adult population. American Journal of Medicine 2013,112(8);1142-7.
9. Wilson JMG,Jungner G. Principles and practice of screening for disease. Geneva: WHO; 1968. Available from: