{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T09:13:10Z","timestamp":1788599590808,"version":"build-2803163510"},"reference-count":27,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,8,30]],"date-time":"2026-08-30T00:00:00Z","timestamp":1788048000000},"content-version":"vor","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"NORSCREEN"},{"name":"Norwegian Regional Health Authorities"},{"name":"Nasjonalt programme for klinisk behandlingsforskning i spesialisthelsetjenesten","award":["22\/00793-5"],"award-info":[{"award-number":["22\/00793-5"]}]},{"DOI":"10.13039\/501100006095","name":"South-Eastern Norway Regional Health Authority","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006095","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Conventional screening modalities for atrial fibrillation (AF) are often constrained by considerable resource and logistical demands. The randomized controlled NORwegian atrial fibrillation self-SCREENing (NORSCREEN) trial employs a fully digital approach to recruitment and implementation. The aim of this pre-specified analysis was to evaluate the effectiveness of the fully digital recruitment and screening strategy, determine the prevalence of screen-detected AF, and assess initial adherence to therapeutic recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Individuals aged \u226565 years with \u22651 additional risk factor for stroke were digitally recruited from the general Norwegian population and randomized 1:1 to screening or usual care. Exclusion criteria included prior AF, anticoagulation, implantable cardiac electronic devices, or lack of smartphone access. Participants allocated to screening were mailed a patch-based electrocardiogram sensor for site-less continuous monitoring over 7 days. Those with diagnosed AF were advised to contact their general practitioner to initiate appropriate therapy. A total of 551 555 Norwegian residents were digitally invited; of these, 139 596 (25.3%) completed the digital eligibility assessment, 74 956 (53.7%) were eligible, and 50 549 (67.4%) were randomized to screening or usual care. The median age was 75 years (inter-quartile range: 69\u201378), 23 445 (46.4%) were female, and the mean CHA2DS2-VA risk score was 2.6 \u00b1 0.9. In the screening group, 19 723 (78.1%) completed the study procedures. Previously undiagnosed AF was identified in 382 (1.9%) screened participants, of whom 366 (95.8%) initiated anticoagulation therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The NORSCREEN trial demonstrates that fully digital, large-scale, site-less AF screening is feasible and effective in an at-risk population, identifying previously undiagnosed AF in 1.9% of screened individuals and showing high adherence to therapeutic recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Trial Registration<\/jats:title>\n                    <jats:p>NCT05914883<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euag140","type":"journal-article","created":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:14:49Z","timestamp":1781612089000},"source":"Crossref","is-referenced-by-count":1,"title":["Digital recruitment and prevalence of screen-detected atrial fibrillation in nationwide patch-based ECG screening: the NORSCREEN randomized clinical trial"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-2156-147X","authenticated-orcid":false,"given":"Miroslav","family":"Boskovic","sequence":"first","affiliation":[{"name":"Institute of Clinical Medicine, University of Oslo , Oslo ,","place":["Norway"]},{"name":"Department of Cardiology, Sorlandet Hospital , Kristiansand ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9031-7620","authenticated-orcid":false,"given":"Marius Bl\u00f8rstad","family":"Haraldsen","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, University of Oslo , Oslo ,","place":["Norway"]},{"name":"Department of Cardiology, Oslo University Hospital Ullevaal , Oslo ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7681-8621","authenticated-orcid":false,"given":"Trygve","family":"Berge","sequence":"additional","affiliation":[{"name":"Department of Medical Research, B\u00e6rum Hospital, Vestre Viken Hospital Trust , Rud ,","place":["Norway"]},{"name":"Department of Medicine, B\u00e6rum Hospital, Vestre Viken Hospital Trust , Rud ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2984-6865","authenticated-orcid":false,"given":"Bj\u00f8rnar Leangen","family":"Grenne","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Thoracic Surgery, St. Olavs Hospital , Trondheim ,","place":["Norway"]},{"name":"Department of Circulation and Medical Imaging, Norwegian University of Science and Technology , Trondheim ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per Torger","family":"Skretteberg","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Oslo University Hospital Ullevaal , Oslo ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1677-7215","authenticated-orcid":false,"given":"Johan","family":"Engdahl","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, Karolinska Institutet, Danderyds Hospital , Stockholm ,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8532-6573","authenticated-orcid":false,"given":"Maja-Lisa","family":"L\u00f8chen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Hospital of North Norway , Troms\u00f8 ,","place":["Norway"]},{"name":"Department of Clinical Medicine, UiT, The Arctic University of Norway , Troms\u00f8 ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4792-197X","authenticated-orcid":false,"given":"Peter","family":"Schuster","sequence":"additional","affiliation":[{"name":"Haukeland University Hospital Department of Cardiology, , Bergen ,","place":["Norway"]},{"name":"University of Bergen Department of Clinical Science, , Bergen ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2009-4764","authenticated-orcid":false,"given":"Jostein","family":"Grimsmo","sequence":"additional","affiliation":[{"name":"Department of Cardiac Rehabilitation, Lovisenberg Rehabilitation, Cathinka Guldbergs Hospital , Jessheim ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1513-8793","authenticated-orcid":false,"given":"Dan","family":"Atar","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, University of Oslo , Oslo ,","place":["Norway"]},{"name":"Department of Cardiology, Oslo University Hospital Ullevaal , Oslo ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4523-8736","authenticated-orcid":false,"given":"Ole-Gunnar","family":"Anfinsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Oslo University Hospital Rikshospitalet , Oslo ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1678-7309","authenticated-orcid":false,"given":"Are Hugo","family":"Pripp","sequence":"additional","affiliation":[{"name":"Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital , Oslo ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0524-9852","authenticated-orcid":false,"given":"Jarle","family":"Jortveit","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Sorlandet Hospital , Arendal ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7561-7644","authenticated-orcid":false,"given":"Sigrun","family":"Halvorsen","sequence":"additional","affiliation":[{"name":"Institute of Clinical Medicine, University of Oslo , Oslo ,","place":["Norway"]},{"name":"Department of Cardiology, Oslo University Hospital Ullevaal , Oslo ,","place":["Norway"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,30]]},"reference":[{"key":"2026090504513911200_euag140-B1","doi-asserted-by":"crossref","first-page":"3314","DOI":"10.1093\/eurheartj\/ehae176","article-title":"2024 ESC guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS)","volume":"45","author":"Van Gelder","year":"2024","journal-title":"Eur Heart J"},{"key":"2026090504513911200_euag140-B2","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1136\/heartjnl-2020-316624","article-title":"Prevalence and incidence rates of atrial fibrillation in Norway 2004\u20132014","volume":"107","author":"Kjerpeseth","year":"2021","journal-title":"Heart"},{"key":"2026090504513911200_euag140-B3","doi-asserted-by":"crossref","first-page":"1468","DOI":"10.1093\/europace\/euz141","article-title":"Prevalence of atrial fibrillation in the Italian elderly population and projections from 2020 to 2060 for Italy and the European Union: the FAI project","volume":"21","author":"Di Carlo","year":"2019","journal-title":"Europace"},{"key":"2026090504513911200_euag140-B4","doi-asserted-by":"crossref","first-page":"1507","DOI":"10.1016\/S0140-6736(21)01698-6","article-title":"Implantable loop recorder detection of atrial fibrillation to prevent stroke (the LOOP study): a randomised controlled trial","volume":"398","author":"Svendsen","year":"2021","journal-title":"Lancet"},{"key":"2026090504513911200_euag140-B5","doi-asserted-by":"crossref","first-page":"1498","DOI":"10.1016\/S0140-6736(21)01637-8","article-title":"Clinical outcomes in systematic screening for atrial fibrillation (STROKESTOP): a multicentre, parallel group, unmasked, randomised controlled trial","volume":"398","author":"Svennberg","year":"2021","journal-title":"Lancet"},{"key":"2026090504513911200_euag140-B6","doi-asserted-by":"crossref","first-page":"e034778","DOI":"10.1136\/bmjopen-2019-034778","article-title":"Adherence to oral anticoagulants among patients with atrial fibrillation: a systematic review and meta-analysis of observational studies","volume":"10","author":"Salmasi","year":"2020","journal-title":"BMJ Open"},{"key":"2026090504513911200_euag140-B7","doi-asserted-by":"crossref","first-page":"2365","DOI":"10.1016\/j.jacc.2019.08.019","article-title":"Mobile photoplethysmographic technology to detect atrial fibrillation","volume":"74","author":"Guo","year":"2019","journal-title":"J Am Coll Cardiol"},{"key":"2026090504513911200_euag140-B8","doi-asserted-by":"crossref","first-page":"1909","DOI":"10.1056\/NEJMoa1901183","article-title":"Large-scale assessment of a smartwatch to identify atrial fibrillation","volume":"381","author":"Perez","year":"2019","journal-title":"N Engl J Med"},{"key":"2026090504513911200_euag140-B9","doi-asserted-by":"crossref","first-page":"1823","DOI":"10.1038\/s41591-022-01979-w","article-title":"Smartphone-based screening for atrial fibrillation: a pragmatic randomized clinical trial","volume":"28","author":"Rizas","year":"2022","journal-title":"Nat Med"},{"key":"2026090504513911200_euag140-B10","doi-asserted-by":"crossref","first-page":"euae228","DOI":"10.1093\/europace\/euae228","article-title":"The NORwegian atrial fibrillation self-SCREENing (NORSCREEN) trial: rationale and design of a randomized controlled trial","volume":"26","author":"Boskovic","year":"2024","journal-title":"Europace"},{"key":"2026090504513911200_euag140-B11","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1378\/chest.09-1584","article-title":"Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation","volume":"137","author":"Lip","year":"2010","journal-title":"Chest"},{"key":"2026090504513911200_euag140-B12","doi-asserted-by":"crossref","first-page":"5230947","DOI":"10.1155\/2021\/5230947","article-title":"Diagnostic accuracy and usability of the ECG247 smart heart sensor compared to conventional Holter technology","volume":"2021","author":"Sandberg","year":"2021","journal-title":"J Healthc Eng"},{"key":"2026090504513911200_euag140-B13","doi-asserted-by":"crossref","first-page":"1349","DOI":"10.1001\/jama.2025.15440","article-title":"Remote screening for asymptomatic atrial fibrillation: the AMALFI randomized clinical trial","volume":"334","author":"Wijesurendra","year":"2025","journal-title":"JAMA"},{"key":"2026090504513911200_euag140-B14","doi-asserted-by":"crossref","first-page":"e082047","DOI":"10.1136\/bmjopen-2023-082047","article-title":"Randomised controlled trial of population screening for atrial fibrillation in people aged 70 years and over to reduce stroke: protocol for the SAFER trial","volume":"14","author":"Mant","year":"2024","journal-title":"BMJ Open"},{"key":"2026090504513911200_euag140-B15","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1001\/jama.2018.8102","article-title":"Effect of a home-based wearable continuous ECG monitoring patch on detection of undiagnosed atrial fibrillation: the mSToPS randomized clinical trial","volume":"320","author":"Steinhubl","year":"2018","journal-title":"JAMA"},{"key":"2026090504513911200_euag140-B16","doi-asserted-by":"crossref","first-page":"1415","DOI":"10.1161\/CIRCULATIONAHA.122.060291","article-title":"Detection of atrial fibrillation in a large population using wearable devices: the Fitbit Heart Study","volume":"146","author":"Lubitz","year":"2022","journal-title":"Circulation"},{"key":"2026090504513911200_euag140-B17","doi-asserted-by":"crossref","first-page":"2216","DOI":"10.1111\/hex.13819","article-title":"Why do people choose not to take part in screening? Qualitative interview study of atrial fibrillation screening nonparticipation","volume":"26","author":"Hoare","year":"2023","journal-title":"Health Expect"},{"key":"2026090504513911200_euag140-B18","doi-asserted-by":"crossref","first-page":"2176","DOI":"10.1161\/CIRCULATIONAHA.114.014343","article-title":"Mass screening for untreated atrial fibrillation: the STROKESTOP study","volume":"131","author":"Svennberg","year":"2015","journal-title":"Circulation"},{"key":"2026090504513911200_euag140-B19","first-page":"4080415","article-title":"Screening for atrial fibrillation by digital health technology in older people in homecare settings: a feasibility trial","volume":"2024","author":"Sandberg","year":"2024","journal-title":"Int J Telemed Appl"},{"key":"2026090504513911200_euag140-B20","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1093\/ehjdh\/ztae026","article-title":"Digital recruitment and compliance to treatment recommendations in the Norwegian atrial fibrillation self-screening pilot study","volume":"5","author":"Sandberg","year":"2024","journal-title":"Eur Heart J Digit Health"},{"key":"2026090504513911200_euag140-B21","doi-asserted-by":"crossref","first-page":"euad075","DOI":"10.1093\/europace\/euad075","article-title":"Fully digital self-screening for atrial fibrillation with patch electrocardiogram","volume":"25","author":"Sandberg","year":"2023","journal-title":"Europace"},{"key":"2026090504513911200_euag140-B22","doi-asserted-by":"crossref","first-page":"f299","DOI":"10.1093\/europace\/eux293","article-title":"Systematic screening for atrial fibrillation in a 65-year-old population with risk factors for stroke: data from the Akershus cardiac examination 1950 study","volume":"20","author":"Berge","year":"2018","journal-title":"Europace"},{"key":"2026090504513911200_euag140-B23","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1002\/clc.23323","article-title":"Intermittent vs continuous electrocardiogram event recording for detection of atrial fibrillation-compliance and ease of use in an ambulatory elderly population","volume":"43","author":"Fredriksson","year":"2020","journal-title":"Clin Cardiol"},{"key":"2026090504513911200_euag140-B24","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.jacep.2024.08.010","article-title":"Atrial fibrillation burden on a 14-day ECG monitor: findings from the GUARD-AF trial screening arm","volume":"11","author":"Singer","year":"2025","journal-title":"JACC Clin Electrophysiol"},{"key":"2026090504513911200_euag140-B25","doi-asserted-by":"crossref","first-page":"euaf019","DOI":"10.1093\/europace\/euaf019","article-title":"Atrial fibrillation burden in clinical practice, research, and technology development: a clinical consensus statement of the European Society of Cardiology Council on Stroke and the European Heart Rhythm Association","volume":"27","author":"Doehner","year":"2025","journal-title":"Europace"},{"key":"2026090504513911200_euag140-B26","doi-asserted-by":"crossref","first-page":"euae181","DOI":"10.1093\/europace\/euae181","article-title":"Reliability of single-lead electrocardiogram interpretation to detect atrial fibrillation: insights from the SAFER feasibility study","volume":"26","author":"Hibbitt","year":"2024","journal-title":"Europace"},{"key":"2026090504513911200_euag140-B27","doi-asserted-by":"crossref","first-page":"euaf190","DOI":"10.1093\/europace\/euaf190","article-title":"Systematic, randomized atrial fibrillation screening using detailed phenotyping with a risk prediction model combined with patch electrocardiogram in a Swedish population aged 65 years or older: the CONSIDERING-AF trial","volume":"27","author":"Rakai","year":"2025","journal-title":"Europace"}],"container-title":["Europace"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/28\/8\/euag140\/70827686\/euag140.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/europace\/article-pdf\/28\/8\/euag140\/70827686\/euag140.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T08:51:56Z","timestamp":1788598316000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/europace\/article\/doi\/10.1093\/europace\/euag140\/8772254"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":27,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2026,8,4]]}},"URL":"https:\/\/doi.org\/10.1093\/europace\/euag140","relation":{},"ISSN":["1099-5129","1532-2092"],"issn-type":[{"value":"1099-5129","type":"print"},{"value":"1532-2092","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,8]]},"published":{"date-parts":[[2026,8]]},"article-number":"euag140"}}