General practitioners' perceptions on opportunistic single-time point screening for atrial fibrillation: A European quantitative survey

Paulien Vermunicht; Mihaela Grecu; Jean-Claude Deharo; Claire M Buckley; Elena Palà; Georges H Mairesse; Michal M Farkowski; Marco Bergonti; Helmut Pürerfellner; Coral L Hanson; Lis Neubeck; Ben Freedman; Henning Witt; Mellanie T Hills; Jenny Lund; Katrina Giskes; Daniel Engler; Renate B Schnabel; Hein Heidbuchel; Lien Desteghe; AFFECT-EU investigators

doi:10.3389/fcvm.2023.1112561

General practitioners' perceptions on opportunistic single-time point screening for atrial fibrillation: A European quantitative survey

Front Cardiovasc Med. 2023 Feb 15:10:1112561. doi: 10.3389/fcvm.2023.1112561. eCollection 2023.

Authors

Paulien Vermunicht^{1

2}, Mihaela Grecu³, Jean-Claude Deharo⁴, Claire M Buckley⁵, Elena Palà⁶, Georges H Mairesse⁷, Michal M Farkowski⁸, Marco Bergonti^{1

2}, Helmut Pürerfellner⁹, Coral L Hanson¹⁰, Lis Neubeck¹⁰, Ben Freedman^{11

12}, Henning Witt¹³, Mellanie T Hills¹⁴, Jenny Lund¹⁵, Katrina Giskes^{11

16}, Daniel Engler^{17

18}, Renate B Schnabel^{17

18}, Hein Heidbuchel^{1

2

19}, Lien Desteghe^{1

2

19

20}; AFFECT-EU investigators

Affiliations

¹ Department of Cardiology, Antwerp University Hospital, Antwerp, Belgium.
² Research Group Cardiovascular Diseases, University of Antwerp, Antwerp, Belgium.
³ Electrophysiology Department, Cardiovascular Diseases Institute, Iasi, Romania.
⁴ Assistance Publique - Hôpitaux de Marseille and Aix Marseille Université, C2VN, Marseille, France.
⁵ School of Public Health, University College Cork, Cork, Ireland.
⁶ Neurovascular Research Laboratory, Vall d'Hebron Institute of Research (VHIR) - Universitat Autónoma de Barcelona, Barcelona, Spain.
⁷ Cliniques du Sud Luxembourg, Arlon, Belgium.
⁸ II Department of Heart Arrhythmia, National Institute of Cardiology, Warszawa, Poland.
⁹ Department of Cardiology, Ordensklinikum Linz Elisabethinen, Linz, Austria.
¹⁰ School of Health and Social Care, Edinburgh Napier University, Edinburgh, United Kingdom.
¹¹ Heart Research Institute, The University of Sydney, Sydney, NSW, Australia.
¹² Charles Perkins Centre and Concord Hospital Cardiology, The University of Sydney, Sydney, NSW, Australia.
¹³ Pfizer Pharma GmbH, Berlin, Germany.
¹⁴ StopAfib.org, Dallas, TX, United States.
¹⁵ Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom.
¹⁶ Department of General Practice, School of Medicine, University of Notre Dame, Sydney, NSW, Australia.
¹⁷ Department of Cardiology, University Heart and Vascular Center Hamburg Eppendorf, Hamburg, Germany.
¹⁸ German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany.
¹⁹ Faculty of Medicine and Life Science, Hasselt University, Hasselt, Belgium.
²⁰ Heart Center Hasselt, Jessa Hospital, Hasselt, Belgium.

Abstract

Background: There is no clear guidance on how to implement opportunistic atrial fibrillation (AF) screening in daily clinical practice.

Objectives: This study evaluated the perception of general practitioners (GPs) about value and practicalities of implementing screening for AF, focusing on opportunistic single-time point screening with a single-lead electrocardiogram (ECG) device.

Methods: A descriptive cross-sectional study was conducted with a survey developed to assess overall perception concerning AF screening, feasibility of opportunistic single-lead ECG screening and implementation requirements and barriers.

Results: A total of 659 responses were collected (36.1% Eastern, 33.4% Western, 12.1% Southern, 10.0% Northern Europe, 8.3% United Kingdom & Ireland). The perceived need for standardized AF screening was rated as 82.7 on a scale from 0 to 100. The vast majority (88.0%) indicated no AF screening program is established in their region. Three out of four GPs (72.1%, lowest in Eastern and Southern Europe) were equipped with a 12-lead ECG, while a single-lead ECG was less common (10.8%, highest in United Kingdom & Ireland). Three in five GPs (59.3%) feel confident ruling out AF on a single-lead ECG strip. Assistance through more education (28.7%) and a tele-healthcare service offering advice on ambiguous tracings (25.2%) would be helpful. Preferred strategies to overcome barriers like insufficient (qualified) staff, included integrating AF screening with other healthcare programs (24.9%) and algorithms to identify patients most suitable for AF screening (24.3%).

Conclusion: GPs perceive a strong need for a standardized AF screening approach. Additional resources may be required to have it widely adopted into clinical practice.

Keywords: AFFECT-EU; atrial fibrillation; general practitioners; screening; survey.

Copyright © 2023 Vermunicht, Grecu, Deharo, Buckley, Palà, Mairesse, Farkowski, Bergonti, Pürerfellner, Hanson, Neubeck, Freedman, Witt, Hills, Lund, Giskes, Engler, Schnabel, Heidbuchel, Desteghe and for the AFFECT-EU investigators.