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Thromb Haemost 2024; 124(01): 061-068
DOI: 10.1055/a-2127-0690
Stroke, Systemic or Venous Thromboembolism

The Report of Community-Based and Government-Endorsed Screening Program of Atrial Fibrillation in Taiwan

Tze-Fan Chao
1   Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
2   Institute of Clinical Medicine and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
,
Yung-Hsin Yeh
3   The Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
4   College of Medicine, Chang Gung University, Taoyuan, Taiwan
,
Yi-Hsin Chan
3   The Cardiovascular Department, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
4   College of Medicine, Chang Gung University, Taoyuan, Taiwan
5   Microscopy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
,
Fang-Ju Lin
6   Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
7   School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
8   Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan
,
Tien-Hsing Chen
4   College of Medicine, Chang Gung University, Taoyuan, Taiwan
9   Department of Cardiology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
,
Kuo-Li Pan
4   College of Medicine, Chang Gung University, Taoyuan, Taiwan
10   Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan
,
Jiunn-Cherng Lin
2   Institute of Clinical Medicine and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
11   Division of Cardiology, Taichung Veterans General Hospital, Chiayi branch, Chiayi, Taiwan
,
Yenn-Jiang Lin
1   Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
2   Institute of Clinical Medicine and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
,
Shih-Ann Chen
1   Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
2   Institute of Clinical Medicine and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
12   Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan
› Author Affiliations Funding This work was supported by grants from the Health Promotion Administration, Ministry of Health and Welfare, Taiwan and Taiwan Heart Rhythm Society.
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Abstract

Background Although international guidelines recommended opportunistic screening for atrial fibrillation (AF), the community-based AF screening program incorporated into the government-endorsed health care system is rarely reported in Asian countries.

Objectives We aimed to test the feasibility of adding AF screening into the preexistent adult health check program and report the AF detection rate and percentages of OAC prescriptions before and after AF screening with the involvement of public health care systems.

Methods We performed this program in three counties (Chiayi county, Keelung City, and Yilan county) in Taiwan which have their own official preexistent adult health check programs conducted by public health bureaus for years. However, electrocardiography (ECG) was not included in these programs before. We cooperated with the public health bureaus of the three counties and performed single-lead 30-second ECG recording for every participant.

Results From January to December 2020, AF screening was performed in 199 sessions with 23,572 participants. AF was detected in 278 subjects with a detection rate of 1.19% (age ≥65 years: 2.39%; ≥75 years: 3.73%). The mean CHA2DS2-VASc score of these 278 subjects was 2.36, with 91% of them had a score ≥1 (males) or ≥2 (females). The number needed to screen was 42 and 27 for subjects aged ≥65 and ≥75 years, respectively. The prescription rate of OACs significantly increased from 11.4 to 60.6% in Chiayi county and from 15.8 to 50.0% in Keelung City after screening (both p-values <0.001).

Conclusion This community-based and government-endorsed AF screening project in Taiwan demonstrated that incorporation of AF screening into the preexistent adult health check programs through co-operations with the government was feasible. Actions to detect AF, good education, and well-organized transferring plan after AF being detected with the involvement of public health care systems could result in a substantial increase in the prescription rate of OACs.

Keywords

atrial fibrillation - screening - detection - government - oral anticoagulants


Publication History

Received: 03 May 2023

Accepted: 10 July 2023

Accepted Manuscript online:
11 July 2023

Article published online:
11 August 2023

© 2023. Thieme. All rights reserved.

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