Clinical outcomes of atrial fibrillation screening: a meta-analysis of randomized controlled trials
Background Several randomized controlled trials (RCTs) have investigated the benefits of atrial fibrillation (AF) screening. However, since none have shown a significant reduction in stroke rates, the impact of screening on clinical outcomes remains uncertain.Materials and methods We conducted a sys...
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Taylor & Francis Group
2025-12-01
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| Series: | Annals of Medicine |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/07853890.2025.2457522 |
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| author | Ville Langén Aleksi K. Winstén K. E. Juhani Airaksinen Konsta Teppo |
| author_facet | Ville Langén Aleksi K. Winstén K. E. Juhani Airaksinen Konsta Teppo |
| author_sort | Ville Langén |
| collection | DOAJ |
| description | Background Several randomized controlled trials (RCTs) have investigated the benefits of atrial fibrillation (AF) screening. However, since none have shown a significant reduction in stroke rates, the impact of screening on clinical outcomes remains uncertain.Materials and methods We conducted a systematic review and meta-analysis of RCTs reporting clinical outcomes of systematic AF screening in participants without known AF. Pooled risk ratios (RRs) were computed for all-cause stroke or systemic embolism, major bleeding, and all-cause mortality, comparing screening with no screening.Results Seven RCTs encompassing 76 458 participants were identified. One trial utilized implantable loop recorders for rhythm monitoring, while the others employed non-invasive screening methods. Pooled results indicated that AF screening was associated with a significant reduction in all-cause stroke or systemic embolism (RR 0.932, 95% CI 0.873–0.996, I2 = 0%, p = 0.037), but had no effect on major bleeding (RR 0.996, 95% CI 0.935–1.060, I2 = 0%, p = 0.876) or all-cause mortality (RR 0.987, 95% CI 0.945–1.031, I2 = 0%, p = 0.550). We estimated a number needed to screen of 148 to prevent one stroke or systemic embolism over a 10-year period in a population of 75-year-olds. When only non-invasive screening methods were considered, the reduction in strokes was not statistically significant (RR 0.942, 95% CI 0.880–1.008, I2 = 0%, p = 0.083).Conclusions Systematic AF screening is associated with a modest yet statistically significant 7% relative reduction in stroke and systemic embolism, with no observed impact on major bleeding or all-cause mortality. |
| format | Article |
| id | doaj-art-2906afe0b312472e9825b6e4b7e8c55b |
| institution | Kabale University |
| issn | 0785-3890 1365-2060 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Annals of Medicine |
| spelling | doaj-art-2906afe0b312472e9825b6e4b7e8c55b2025-01-25T16:09:18ZengTaylor & Francis GroupAnnals of Medicine0785-38901365-20602025-12-0157110.1080/07853890.2025.2457522Clinical outcomes of atrial fibrillation screening: a meta-analysis of randomized controlled trialsVille Langén0Aleksi K. Winstén1K. E. Juhani Airaksinen2Konsta Teppo3Division of Medicine, Turku University Hospital and University of Turku, Turku, FinlandFaculty of Medicine, Department of Mathematics and Statistics, University of Turku, Turku, FinlandTurku University Hospital and University of Turku, Turku, FinlandHeart Centre, Turku University Hospital, Turku, FinlandBackground Several randomized controlled trials (RCTs) have investigated the benefits of atrial fibrillation (AF) screening. However, since none have shown a significant reduction in stroke rates, the impact of screening on clinical outcomes remains uncertain.Materials and methods We conducted a systematic review and meta-analysis of RCTs reporting clinical outcomes of systematic AF screening in participants without known AF. Pooled risk ratios (RRs) were computed for all-cause stroke or systemic embolism, major bleeding, and all-cause mortality, comparing screening with no screening.Results Seven RCTs encompassing 76 458 participants were identified. One trial utilized implantable loop recorders for rhythm monitoring, while the others employed non-invasive screening methods. Pooled results indicated that AF screening was associated with a significant reduction in all-cause stroke or systemic embolism (RR 0.932, 95% CI 0.873–0.996, I2 = 0%, p = 0.037), but had no effect on major bleeding (RR 0.996, 95% CI 0.935–1.060, I2 = 0%, p = 0.876) or all-cause mortality (RR 0.987, 95% CI 0.945–1.031, I2 = 0%, p = 0.550). We estimated a number needed to screen of 148 to prevent one stroke or systemic embolism over a 10-year period in a population of 75-year-olds. When only non-invasive screening methods were considered, the reduction in strokes was not statistically significant (RR 0.942, 95% CI 0.880–1.008, I2 = 0%, p = 0.083).Conclusions Systematic AF screening is associated with a modest yet statistically significant 7% relative reduction in stroke and systemic embolism, with no observed impact on major bleeding or all-cause mortality.https://www.tandfonline.com/doi/10.1080/07853890.2025.2457522Atrial fibrillationscreeningoutcomesstrokebleedingmortality |
| spellingShingle | Ville Langén Aleksi K. Winstén K. E. Juhani Airaksinen Konsta Teppo Clinical outcomes of atrial fibrillation screening: a meta-analysis of randomized controlled trials Annals of Medicine Atrial fibrillation screening outcomes stroke bleeding mortality |
| title | Clinical outcomes of atrial fibrillation screening: a meta-analysis of randomized controlled trials |
| title_full | Clinical outcomes of atrial fibrillation screening: a meta-analysis of randomized controlled trials |
| title_fullStr | Clinical outcomes of atrial fibrillation screening: a meta-analysis of randomized controlled trials |
| title_full_unstemmed | Clinical outcomes of atrial fibrillation screening: a meta-analysis of randomized controlled trials |
| title_short | Clinical outcomes of atrial fibrillation screening: a meta-analysis of randomized controlled trials |
| title_sort | clinical outcomes of atrial fibrillation screening a meta analysis of randomized controlled trials |
| topic | Atrial fibrillation screening outcomes stroke bleeding mortality |
| url | https://www.tandfonline.com/doi/10.1080/07853890.2025.2457522 |
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