In this week's BMJ, Mant and colleagues and Fitzmaurice and colleagues present the results of the SAFE (screening for atrial fibrillation in the elderly) study. They assess how accurately general practitioners, practice nurses, and an interpretive computer program can diagnose atrial fibrillation on an electrocardiogram (ECG), and they report on the effectiveness of screening patients aged 65 and over for atrial fibrillation in British general practice.1 2 The prevalence of atrial fibrillation rises with age from 1.5% in people in their 60s to more than 10% in those over 90. People with atrial fibrillation have double the mortality and a four to fivefold higher risk of stroke than those without fibrillation. About a quarter of all strokes in elderly people are caused by atrial fibrillation. Strokes caused by atrial fibrillation are often severe and lead to high mortality and a low quality of life.3 Join discussion...

A Report From the Heart Rhythm Society: Expert Consensus Statement on Catheter and Surgical Ablation of Atrial Fibrillation from Europace. Join discussion...

ctive screening for atrial fibrillation detects additional cases over current practice. The preferred method of screening in patients aged 65 or over in primary care is opportunistic pulse taking with follow-up electrocardiography. Join discussion...

Adjusted-dose warfarin and antiplatelet agents reduce stroke by approximately 60% and by approximately 20%, respectively, in patients who have atrial fibrillation. Warfarin is substantially more efficacious (by approximately 40%) than antiplatelet therapy. Absolute increases in major extracranial hemorrhage associated with antithrombotic therapy in participants from the trials included in this meta-analysis were less than the absolute reductions in stroke. Judicious use of antithrombotic therapy Join discussion...

Researchers from the Icelandic company deCODE Genetics have identified a strong association between two sequence variants on chromosome 4 and the risk of atrial fibrillation in both white and Chinese populations [1]. Dr Daniel F Gudbjartsson (deCODE Genetics) and colleagues report their findings online July 1, 2007 in Nature. Join discussion...