- Question
- Does atrial fibrillation (AF) screening with a single-lead ECG during primary care visits increase new AF diagnoses in older adults?
- Design
- Cluster-randomized trial of 16 primary care clinics assigned 1:1, open-label. A total of 30715 patients without prevalent AF were analyzed, with 1-year follow-up and manual adjudication of new diagnoses.
- Population
- Patients aged 65 years or older seen in primary care clinics, without a prior diagnosis of AF.
- Intervention
- Screening with a handheld single-lead ECG (AliveCor KardiaMobile) during vital sign assessment at the visit; results were given to the clinician at the encounter, and 91% of the screening group was screened.
- Control
- Usual care, with no systematic screening.
- Primary outcome
- Incidence of new AF diagnosed during 1 year of follow-up.
- Results
- New AF was diagnosed in 1.72% of the screening group versus 1.59% of the control group (risk difference 0.13%; 95% CI -0.16 to 0.42; P=0.38). In the subgroup aged 85 years or older, screening yielded more diagnoses (5.56% vs 3.76%; risk difference 1.80%; 95% CI 0.18 to 3.30).
- Safety
- The published results report no specific safety findings; among patients with new AF, initiation of oral anticoagulation was similar between arms (73.5% vs 70.8%).
- Conclusion
- Single-lead ECG screening at primary care visits did not change new AF diagnoses across all adults aged 65 years or older compared with usual care.
- Why it matters
- It provided randomized evidence that opportunistic screening with a single-lead device in general practice does not globally increase AF detection, although it may be more productive in the oldest patients.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 18, 2026