Electrocardiographic screening in primary care for cardiovascular disease risk and atrial fibrillation.
Ralf E HarskampPublished in: Primary health care research & development (2019)
Electrocardiograms (ECGs) are frequently recorded in primary care for screening purposes. An ECG is essential in diagnosing atrial fibrillation, and ECG abnormalities are associated with cardiovascular events. While recent studies show that ECGs adequately reclassify a proportion of patients based on the clinical risk score calculations, there are no data to support that this also results in improved health outcomes. When applied for screening for atrial fibrillation, more cases are found with routine care, but this would be undone when physicians would perform systematic pulse palpation. In most studies, the harms of routine ECG use (such as unnecessary diagnostic testing, emotional distress, increased health expenses) were poorly documented. As such, the routine performing of ECGs in asymptomatic primary care patients, whether it is for cardiovascular disease risk assessment or atrial fibrillation, cannot be recommended.
Keyphrases
- primary care
- atrial fibrillation
- cardiovascular disease
- cardiovascular events
- end stage renal disease
- left atrial
- risk assessment
- healthcare
- ejection fraction
- oral anticoagulants
- newly diagnosed
- chronic kidney disease
- heart failure
- left atrial appendage
- coronary artery disease
- direct oral anticoagulants
- prognostic factors
- heart rate variability
- heart rate
- clinical practice
- blood pressure
- palliative care
- mental health
- percutaneous coronary intervention
- venous thromboembolism
- metabolic syndrome
- climate change
- molecular dynamics simulations
- cardiovascular risk factors
- data analysis
- big data
- electronic health record
- chronic pain