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Cardiovascular diseases are the most common cause of mortality and morbidity in adults worldwide.1 Coronary angiography (CAG) is the gold standard method for evaluating atherosclerotic coronary artery disease (CAD).2 It is conventionally performed via the trans-femoral (TF) route. Recently, however, the trans-radial (TR) route has become the preferred way.3 The TR route offers better procedure comfort, shorter hospitalization […]

Søren Zöga Diederichsen, EHRA 2023: The limitations of current approaches for atrial fibrillation screening

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Published Online: May 25th 2023

The STROKESTOP and the LOOP studies have assessed the use of atrial fibrillation screening compared with usual care. In this touchCARDIO interview, we speak with Dr Søren Zöga Diederichsen (Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark) to discuss the limitations of current atrial fibrillation screening.

Søren Zöga Diederichsen presented an abstract entitled ‘Atrial fibrillation screening to prevent stroke in patients with high NT-proBNP – a post-hoc analysis of the randomized LOOP study’ at the European Heart Rhythm Association congress, 16–18, April 2023.

Click here to view the LOOP study post hoc analysis discussion and here to view the published article.

Question:

What are the limitations of current approaches for atrial fibrillation screening? (0:15)

Disclosures: Søren Zöga Diederichsen is a consultant for Cortrium and Vital Beats, on the advisory board for Acesion Pharma, Bristol Myers Squibb and Pfizer, and is on the speaker’s bureau Bayer, Bristol Myers Squibb and Pfizer.

Support: Interview and filming supported by Touch Medical Media. Interview conducted by Danielle Crosby.

Filmed as a highlight of EHRA 2023

Access more content on atrial fibrillation here

 

Transcript:

Hi I’m Søren Zoega Diederichsen from University Hospital Copenhagen, Rigshospitalet. 

Q. What are the limitations of current approaches for atrial fibrillation screening?

Atrial fibrillation screening has a lot of limitations at this moment. First off, we have not really been able to show that atrial fibrillation screening is beneficial in terms of outcomes. We know that atrial fibrillation screening detects more atrial fibrillation than no screening, but this is not enough. 

There have been two large randomized trials looking at atrial fibrillation screening compared with usual care with respect to heart outcomes. One is the LOOP study in which persons with age and comorbidities were recruited to be screened with an implantable loop recorder versus usual care. Another trial is the STROKESTOP trial, looking at age as the only criterion for atrial fibrillation screening. 

The STROKESTOP trial was actually a positive trial, but there was a very small effect size, and there were other limitations with this trial. And the LOOP study was a neutral trial in terms of outcomes. So these two studies are sort of showing that we can detect a lot of atrial fibrillation and there are signals that we can also prevent strokes. But now we have reported a substudy of the LOOP study to look a little bit more if we can refine the population that will actually benefit from being diagnosed through screening. 

Subtitles and transcript are autogenerated

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