Characteristics and health-status outcomes in patients with atrial fibrillation detected via health screening

Background: Early detection of atrial fibrillation (AF) is important. Japan has a universal screening system, and regular health screening (HS) is available to support AF detection without a hospital visit. However, health-related outcomes and other characteristics of HS-detected and conventionally diagnosed AF remain unknown. Hypothesis: That the characteristics and health-related outcomes of patients with HS-detected AF may differ from those of patients whose AF was detected by other procedures. Methods: In total, 3318 consecutive newly referred AF cases were enrolled; demographic characteristics and health-related and clinical outcomes were compared between two groups created based on the mode of AF detection (the HS and non-HS groups). Health-related outcomes were assessed using the AF Effect on QualiTy-of-life (AFEQT) questionnaire at baseline and after 1 year of follow-up. Results: AF was detected by HS in 25.0% of patients; these patients had lower CHADS₂ scores (1.01 vs. 1.50, p <.001), higher prevalence of persistent AF (odds ratio, 95% confidence interval; 2.21, 1.88–2.60) and asymptomatic presentation (3.19, 2.71–3.76), and better baseline QoL scores (83.6 vs. 75.0; p <.001). Catheter ablation was more frequently performed in the HS group at follow-up (44.4% vs. 34.1%; p <.001). At 1-year follow-up, the AFEQT scores of the HS group were significantly better in most subdomains. Conclusions: In the Japanese registry, AF was detected via HS in 25% of patients referred to specialty centers for management. Notably, the overall health status of patients with HS-detected AF improved after medical interventions, including catheter ablations.