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Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
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0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
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01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
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Rationale and design of the "Screening of Atrial Fibrillation among elderly in primary care with MyDiagnostik" (SAFEST) study
Session:
Painel 4 - Arritmologia 5
Speaker:
Pedro Miguel Gonçalves Teixeira
Congress:
CPC 2020
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.3 Atrial Fibrillation - Diagnostic Methods
Session Type:
Posters
FP Number:
---
Authors:
Pedro Gonçalves Teixeira; Ricardo Fontes-Carvalho; Rui Baptista; Daniel Caldeira
Abstract
<p>INTRODUCTION: Previous epidemiologic studies showed a high prevalence of atrial fibrillation (AF) in the elderly Portuguese population, which is frequently underdiagnosed, with suboptimal rates of oral anticoagulation (OAC) and effective control of cardiovascular risk factors. Recent studies have demonstrated that 45% of all AF-related strokes occurred in patients with asymptomatic and unknown AF. Screening and searching for AF may have a potential role preventing complications if adequate treatment is prescribed early.</p> <p>PURPOSE: To determine the diagnostic yield (number needed to screen) of an opportunistic screening strategy of AF in elderly with Mydiagnostick, and to assess the impact of screening-based AF diagnosis on the 6-month OAC adherence rate.</p> <p>METHODS: This registry is a prospective multicentric study. We will perform opportunistic screening for Atrial Fibrillation among the elder population (>65 years) in 27 Primary Care Health Centers, in Portuguese rural areas. Subjects over 65 years, without previously diagnosed AF, that accept to participate in the study will be performing a non-invasive and quick AF diagnostic test with a hand-held single-lead ECG device (MyDiagnostick) during their routine GP consultation. Subjects with an AF detection by the device will perform an ECG, which will be remotely evaluated by the Investigators in order to confirm the AF diagnosis. After Subject’s GP notification, subjects with AF are supposed to be treated according to current medical guidelines. The study has no exclusion criteria. Considering a potential of 1.3% new-cases of AF (according to previous data on AF incidence in this age group), a margin of error of 0.3%, and a C.I. of 99%, the sample size required for this study is 9411 patients. The recruitment period is estimated to be 6 months. At 6 months follow-up, major adverse cardiovascular and cerebrovascular events will be recorded, along with any-cause and cardiovascular mortality. Analysis of OAC therapy adherence rate is also pre-specified.</p> <p>CONCLUSION To our knowledge, no study using simple devices for opportunistic screening of AF in the elderly, with a particular focus on rural areas, was performed to date. Detecting asymptomatic AF would provide an opportunity to reduce ischaemic stroke incidence in these patients, by instituting appropriate OAC. Also, improving AF diagnosis in rural areas may have a great population-level benefit, by attenuating regional differences in the level of health care, and minimizing the burden of other AF-related complications.</p>
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