{"id":"5befd3ddfb97","type":"article","url":"https://hartvaat.nl/2022/03/29/af-screening-bij-ouderen-in-de-huisartsenpraktijk-vital-af-gerandomiseerde-trial/","title":"AF-screening bij ouderen in de huisartsenpraktijk: VITAL-AF gerandomiseerde trial","title_en":"Screening for Atrial Fibrillation in Older Adults at Primary Care Visits: VITAL-AF Randomized Controlled Trial.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog","huisarts"],"tags":["primaire-preventie"],"journal":"Circulation","doi":"10.1161/CIRCULATIONAHA.121.057014","source_url":"https://doi.org/10.1161/CIRCULATIONAHA.121.057014","authors":["Steven A Lubitz","Steven J Atlas","Jeffrey M Ashburner","Ana T Trisini Lipsanopoulos","Leila H Borowsky","Wyliena Guan","Shaan Khurshid","Patrick T Ellinor","Yuchiao Chang","David D McManus","Daniel E Singer"],"significance":7,"published":"2022-03-29","source_date":"2022-03-29","image":"","kennis":["https://hartvaat.nl/kennis/atriumfibrilleren/af-bij-ouderen/"],"congress":"","summary_en":"The VITAL-AF pragmatic trial of point-of-care AF screening during primary care visits showed that single-time-point screening modestly increases AF detection but has limited yield in the broader older adult population.","created":"2026-07-03T10:29:40Z","updated":"2026-07-03T13:28:47Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"VITAL-AF gerandomiseerde trial die AF-screening evalueerde bij ouderen tijdens huisartsenbezoeken. Pragmatische screening.","abstract_original":"BACKGROUND: Undiagnosed atrial fibrillation (AF) may cause preventable strokes. Guidelines differ regarding AF screening recommendations. We tested whether point-of-care screening with a handheld single-lead ECG at primary care practice visits increases diagnoses of AF. METHODS: We randomized 16 primary care clinics 1:1 to AF screening using a handheld single-lead ECG (AliveCor KardiaMobile) during vital sign assessments, or usual care. Patients included were ages ≥65 years. Screening results were provided to primary care clinicians at the encounter. All confirmatory diagnostic testing and treatment decisions were made by the primary care clinician. New AF diagnoses during the 1-year follow-up were ascertained electronically and manually adjudicated. Proportions and incidence rates were calculated. Effect heterogeneity was assessed. RESULTS: Of 30 715 patients without prevalent AF (n=15 393 screening [91% screened], n=15 322 control), 1.72% of individuals in the screening group had new AF diagnosed at 1 year versus 1.59% in the control group (risk difference, 0.13% [95% CI, -0.16 to 0.42]; P=0.38). In prespecified subgroup analyses, new AF diagnoses in the screening and control groups were greater among those aged ≥85 years (5.56% versus 3.76%, respectively; risk difference, 1.80% [95% CI, 0.18 to 3.30]). The difference in newly diagnosed AF between the screening period and the previous year was marginally greater in the screening versus control group (0.32% versus -0.12%; risk difference, 0.43% [95% CI, -0.01 to 0.84]). The proportion of individuals with newly diagnosed AF who were initiated on oral anticoagulants was not different in the screening (n=194, 73.5%) and control (n=172, 70.8%) arms (risk difference, 2.7% [95% CI, -5.5 to 10.4]). CONCLUSIONS: Screening for AF using a single-lead ECG at primary care visits did not affect new AF diagnoses among all individuals aged 65 years or older compared with usual care. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT03515057."}