Abstract
BACKGROUND: Patient characteristics and outcomes of newly diagnosed atrial fibrillation (AF) have been investigated in large registries. OBJECTIVE: The study aimed to address the role of non-invasive screening tools in diagnosing AF in the Argentinian clinical practice. METHODS: This was an observational retrospective study. Patients' clinical characteristics and management of newly diagnosed AF detected by a non-invasive screening tool were analyzed. RESULTS: Of 12,635 AF outpatients, 1018/5947 (17.1%) of newly diagnosed AF were detected by a screening method: electrocardiography monitoring device (82.3%), self-pulse palpation (17.3%), and smartwatch/smartphone (0.4%).Screening (+) patients were older (73 years [63-81] vs 72 [65-81], P = not significant) and had a higher prevalence of ≥ 75 year-old patients (45.5% vs 37.9%, P < .001) and women (42.5% vs 41.2%, P = not significant).Adjusted results (odds ratio [95% confidence interval]) by multivariate analysis showed that alcohol consumption (1.74 [1.14-2.65]), thyroid dysfunction (1.26 [1.07-1.49]), coronary artery disease (1.40 [1.19-1.64]), paroxysmal AF (2.39 [1.94-2.96]), asymptomatic condition (2.44 [2.07-2.86]), high risk of thromboembolic and bleeding complications (CHA(2)DS(2)-Vasc, 1.18 [1.06-1.32] and HASBLED, 1.25 [1.08-1.46]), and heart failure (1.23 [1.01-1.49]) were associated with screening (+) patients. Although no difference in the oral anticoagulation therapy was detected, vitamin K antagonists were less frequently prescribed (0.66 [0.53-0.82]). Electrical cardioversion was preferred over class I and III antiarrhythmic drugs (1.33 [1.07-1.66] vs 0.61 [0.44-0.84] and 0.79 [0.64-0.97]). CONCLUSION: Non-invasive screening tools are mainly used in Argentinian clinical practice to detect AF in asymptomatic patients at high risk of thromboembolic and bleeding complications. Vitamin K antagonists are less prescribed, and electrical cardioversion is preferred over antiarrhythmic drugs for initial rhythm control.