Screening for atrial fibrillation and other arrhythmias in primary care

BMC Family Practice

Cindy Kok¹  Kam Cheong Wong²  Clara K. Chow²  Tim Usherwood²  Simone Marschner² 

[1] Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Royal North Shore Hospital;Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Westmead Hospital;

关键词: Atrial fibrillation;    Arrhythmia;    Screening;    Electrocardiography;    Electrocardiogram;    Mobile health;   

DOI  :  10.1186/s12875-020-01151-8

来源: DOAJ

【 摘 要 】

Abstract Background Atrial fibrillation (AF) and other arrhythmias are prevalent and often encountered by general practitioners (GPs). In response to the growing prevalence and to assist practitioners in the diagnosis and management of AF, the Cardiac Society of Australia & New Zealand and Heart Foundation of Australia published the first Australian AF Guidelines in 2018. We aimed to examine (a) the proportion of GPs who performed any form of AF screening and identify the methods they applied, (b) GPs’ awareness of the AF Guidelines and approaches to arrhythmia screening, (c) the roles of conventional 12-lead ECG and mobile health devices, and (d) GPs’ confidence in ECG interpretation and need for training. Methods A cross-sectional online survey titled “GPs Screen their patients for Atrial Fibrillation and othEr aRrhythmia (GPSAFER)” was conducted from October 2018 to March 2019. The participants were recruited via various GP networks across Australia. Ethics approval was granted by The University of Sydney. Results A total of 463 surveys were completed. Many GPs (394/463, 85.1%, 95% CI 81.5–88.2%) performed some forms of AF screening and applied at least one AF screening method, most frequently pulse palpation (389/463, 84.0%). Some (299/463, 64.6%) GPs considered assessing their patients for other arrhythmias (237/299, 79.3% for complete heart block and 236/299, 78.9% for long-QT). Most GPs (424/463, 91.6%) were not using mobile ECG devices in their practice but some (147/463, 31.7%) were contemplating it. One third (175/463, 37.8%) of GPs were aware of the Australian AF Guidelines; those aware were more likely to perform AF screening (98.9% vs 76.7%, p <  0.001). Factors significantly and positively associated with AF screening were “awareness of the AF Guidelines” (p <  0.001), “number of years working in general practice” (p <  0.001), and “confidence in ECG interpretation of AF” (p = 0.003). Most GPs reported that they were very or extremely confident in interpreting AF (381/463, 82.3%) and complete heart block (266/463, 57.5%). Many GPs (349/463, 75.4%) would like to receive online ECG interpretation training. Conclusions Assessment of arrhythmias is common in general practice and GPs are open to further training in ECG interpretation and using mobile ECG devices to aid their clinical practice. Increasing awareness of AF Guidelines and improving confidence in ECG interpretation may increase AF screening.

【 授权许可】

Unknown