Atrial fibrillation (AF) is the most common recurrent arrhythmia in Australia, with estimates suggesting that approximately 2–4% of the Australian population has AF and prevalence increasing with age.1,2 It is expected that AF cases in people aged ≥55 years will increase over the next 20 years due to the ageing population and improved survival from contributory diseases.1
AF can be persistent or paroxysmal. Although AF can be symptomatic (transient ischaemic attack [TIA], stroke, breathlessness, reduced exercise capacity, palpitations, syncope or dizziness, fatigue, weakness, chest discomfort),2–4 it can also be asymptomatic.1 Clinical AF is known to increase stroke risk,5,6 but the stroke risk associated with subclinical AF, particularly low-burden or short-duration AF, is less well understood.5,7,8 As of 2018, AF was listed as the underlying or associated cause of over 14,000 deaths in Australia (9.0% of total deaths).2
Screening for AF in asymptomatic people is undertaken to determine whether someone is at sufficiently high risk to require oral anticoagulants to prevent a thromboembolic event.