Intended for healthcare professionals

Rapid response to:

Head To Head

Should we screen for atrial fibrillation?

BMJ 2019; 364 doi: https://doi.org/10.1136/bmj.l43 (Published 13 February 2019) Cite this as: BMJ 2019;364:l43

Rapid Response:

Re: Should we screen for atrial fibrillation?

Again a debate on af with little or no mention of patient choice either to be screened and labelled or treated.
No mention of the real world risk of bleeding (if indeed these figures are even remotely known to be true).
My main question though is the mathematics.

On the yes side we are told that there is a 7% mortality over 1.5 years in people with af and in the references up to 35% detected with af through screening. This would suggest many more deaths than seem to occur. What have I missed?

The debate needs the trial to answer, not opinion before the evidence.
It is interesting that this article appeared in the same BMJ issue as the article telling us that many years of shoulder surgery is probably not beneficial even when compared to physio, which in previous BMJ articles has also been shown to be of no long term benefit.

Competing interests: No competing interests

19 February 2019
nicholas sharvill
GP
Deal Kent