If you have symptoms of atrial fibrillation, it’s important to get a thorough diagnosis. But what if you are just an older adult worried that you might have afib and not know it? Should you ask your doctor to check?
Preventive testing for undiagnosed health problems is known as screening. Screening for afib remains somewhat controversial. The American Heart Association’s guideline for stroke prevention has stated that afib screening is “potentially useful” for adults 65 and older. Meanwhile, in 2020 the European Society of Cardiology fully endorsed afib screening while also acknowledging the need for better evidence to demonstrate its health benefits.
However, in January 2022, the influential U.S. Preventive Services Task Force, an independent body that evaluates evidence regarding preventive care, concluded that the scientific evidence to date isn’t strong enough to back routine, widespread screening for afib in adults ages 50 or older. (See also “Spotting afib with wearables,” page 5.)
On one hand, early diagnosis and treatment may lead to better long-term results, depending on the condition. But the evidence is crucial, since many people diagnosed with afib after preventive screening would end up taking anticoagulants, which come with the risk of unwanted bleeding. It remains a bit uncertain whether screening potentially millions of older adults would prevent enough strokes to justify its costs and risks. As technologies evolve, guidelines and the advice your doctor gives you may also change.
Your doctor may suggest an ECG at some point on the chance you may have hidden afib. The decision to screen will depend on your risk factors for the condition, especially older age. Research is under way to establish who can benefit the most from being screened for atrial fibrillation even if they have not noticed symptoms. In the meantime, if you are concerned about afib, ask your doctor for an opinion