Screening for atrial fibrillation in older adults in primary care: a cross-sectional pilot study in Qatar

<title>Abstract</title> <bold>Background</bold> Atrial fibrillation (AF) is the most common arrhythmia in clinical practice, and its prevalence is increasing in aging populations. It is a leading cause of acute stroke, heart failure, sudden death, and other cardiovascular morbidities. AF is often asymptomatic and is frequently diagnosed late, typically after a patient presents with acute stroke. Early detection and treatment can prevent such life-threatening events, making AF screening a public health priority. However, diagnosing asymptomatic AF remains challenging. While international guidelines recommend AF screening, Qatar lacks documented prevalence data and formal screening programs. This study aimed to assess the feasibility of an AF screening program for older adults in Qatar. <bold>Methods</bold> A cross-sectional study was conducted among individuals aged ≥65 years registered with the Primary Health Care Corporation (PHCC)-Qatar, which serves approximately 70% of Qatar’s population. A simple random sample of 139 to 385 individuals was determined to ensure a sampling error of 5% to 3%, assuming a 10% AF prevalence. The participants underwent screening via standard ECG tracing that were reviewed independently by both the family physicians and a cardiologist. <bold>Results</bold> The prevalence of AF among the study population was 5.4%. Newly diagnosed cases accounted for 2% of the 249 participants screened. All newly detected patients had a CHA2DS2VASc scores indicating the need for anticoagulant therapy to reduce stroke risk. Furthermore, compared with cardiologists, the family physicians in primary care successfully identified 75% of AF cases through ECG. <bold>Conclusions</bold> If implemented nationally among individuals aged ≥65 years, the screening program could identify 747 undiagnosed AF cases among the 37,371. AF screening for individuals aged ≥75 years appears to offer a favorable cost‒benefit ratio, supporting the implementation of a targeted screening strategy in Qatar.