We working with GP practices across England. Practice staff identify people aged 70 and over who may be eligible to take part, and invite them to participate in the trial. Once the practice has recruited enough patients it will be randomised to either control or AF screening. Randomisation is just allocating by chance, like tossing a coin. For every practice randomised to AF screening, two practices will be randomised to control. This reduces the cost of the trial.
Participants in practices that are randomised to deliver AF screening will be invited to take part in screening at home. The simple, non-invasive hand-held ECG recording device will be sent to the participant at home with full instructions for how to use it. Participants will be asked to use the ECG device for 3 weeks and record an ECG 4 times a day, and if they feel their heart is beating irregularly. The participant will return the device to the research team by post.
Recorded ECG traces will be transmitted by the device to a central database, where they will be assessed by the system algorithm. Traces tagged by the system as being possible AF will be reviewed by a cardiologist who will confirm the diagnosis. This result will be fed back to the practices who will inform the participants.
For more information about the single-lead ECG device click here.
Participants found to have AF will be invited to attend a consultation with their GP to discuss blood thinning (anticoagulation) therapy, in accordance with national guidelines. Anticoagulation therapy reduces the increased risk of stroke and heart attack associated with AF. The GP consultation may be conducted by phone or in person, following the policies at the individual practice at that time.
Participants in control practices will not be invited to take part in screening for AF.
Whether you take part in AF screening or not, you continue to make a valuable contribution to the trial by allowing certain information from your NHS records to be shared with the research team. Collecting this information will help us to understand whether screening for AF makes a difference, by comparing information about people who do and do not undergo AF screening.