Abstracts by keywords: Atrial fibrillation
Screening for atrial fibrillation (AF) is recommended in the guidelines of the European Society of Cardiology (ESC) (Hindricks et al. 2020), but is currently not implemented in the form of systematic health programs in Germany. Given demographic changes and the age-dependent occurrence of AF, it is predicted that by 2060 the number of patients aged over 65 years with AF in Europe will increase to over 14 million (Krijthe et al. 2013). Since AF is a relevant risk factor for stroke, screening for AF will become increasingly important. In order to be able to assess the possible effects of introducing guideline-based screening for AF in the German health care context - in particular to avoid long-term health and health economic consequences - a systematic literature search was carried out in 2019. No evidence could be identified from completed, prospective studies in the German health care context that report long-term clinically relevant events after screening for AF. Against this background, a Markov model was developed with which the effects of a screening for AF can be simulated. This model is intended to contribute to the professional public discussion on the detection of AF and the prevention of thromboembolic events and to enable the derivation of adequate measures for better care. For this work, on the one hand, the long-term effects of consistent implementation of the screening measures provided for in the ESC guidelines with regard to the prevention of AF-associated strokes and systemic embolism were examined. On the other hand, the direct health economic implications were considered from the perspective of statutory health insurance (SHI).
29.01.2022
Atrial fibrillation (AF) is one of the most common cardiac arrhythmias in adults with a high number of unreported cases and increasing prevalence. AF patients have an increased risk of death and illness, for example from strokes. Strokes, on the other hand, are life-threatening events and the most common reason for permanent disability in adulthood. They are associated with considerable medical expenses. The primary and secondary prevention of a stroke in AF is therefore of great importance. It starts with treating the cause of the AF. Oral anticoagulation (OAC) is also an effective medical method to prevent strokes in AF patients. This article is based on findings from the white paper “Stroke Prevention in Atrial Fibrillation” published by the IGES Institute in September 2015 and has been supplemented by information that has been published since then. The care recommendations presented in the white paper are based, among other things, on discussions with experts from the fields of cardiology, neurology, primary care, patient representation and health insurance.