Atrial Fibrillation Screening in High-Risk Patients Using a Single Lead ECG Device: A Tertiary Hospital Experience

Background Atrial Fibrillation (AF) is a major public health problem and one of the commonest supraventricular arrhythmias. At least 20% of all strokes are directly attributable to AF. However, its burden is not clear in sub-Saharan Africa, possibly due in part to undervaluation and non-recognition. In recent decades several new devices have been developed for the betterment of the accuracy and rates of AF detection, which also offers flexibility and feasibility. Objective The objective of the study is to identify the prevalence of known and Unknown AF in a high-risk patient population using a validated single-lead ECG. Methods and materials An institution-based cross-sectional study was conducted in 410 adults (≥55 years) recruited from Tikur Anbessa hospital sub-specialty outpatient clinics from July to October 2021. ECG tracing was conducted using (AliveCor) SL ECG device. A standardized questionnaire was designed to collect socio-demographic and clinical information using ODK Collect v2021. 3.0. we used logistic regression to determine the potential associated factors. Results The overall prevalence of AF in our study was 4.8%. It was strongly associated with age, diagnosis of heart failure, Substance use and high monthly income according to World Bank (WB) category. All the newly diagnosed patients were not on anticoagulation for stroke prevention. Conclusion and Recommendations Single timepoint screening in high-risk patients identified previously unknown AF in 2.1 %, out of which the majority were eligible for anticoagulation therapy. Identification of AF through targeted screening with up incoming novel technologies could reduce the stroke burden associated with undiagnosed AF. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement No External Funding is provided ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: IRB Board of Department of Internal Medicine School of medicine, College of health sciences Addis Ababa University I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data is available in the manuscript