{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,8]],"date-time":"2026-02-08T04:16:24Z","timestamp":1770524184879,"version":"3.49.0"},"reference-count":21,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T00:00:00Z","timestamp":1609286400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Bayer Yakuhin, Ltd."}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>Cardio-embolic ischemic stroke caused by atrial fibrillation is more severe compared with other types of stroke, such as lacunar infarction and atherothrombotic infarction in patients without atrial fibrillation. Therefore, it is important to prevent cardio-embolic ischemic stroke by detecting atrial fibrillation early in at-risk patients and administering appropriate anticoagulation therapy. This prospective observational study aimed to evaluate the effectiveness of opportunistic atrial fibrillation screening at 12 primary clinics in Japan. The study included a 12-month pre-campaign period and a 12-month campaign period. During the campaign period, an awareness campaign was conducted to encourage physicians to be mindful of screening patients aged \u226565 years for atrial fibrillation by checking their pulses and performing subsequent electrocardiography when an irregular pulse was detected. The primary outcome was the proportion of patients with newly diagnosed atrial fibrillation. A sub-analysis focusing on first-time outpatients was performed. There were 9921 and 10,282 patients with no history of atrial fibrillation in the pre-campaign and campaign periods, respectively. In the whole population, the proportion of patients with newly diagnosed atrial fibrillation was 0.9% throughout the pre-campaign and campaign periods. In the sub-analysis limited to first-time outpatients, the detection proportion increased from 1.6% to 1.9% during the campaign period. In terms of age stratification, a large increase in detection was observed, especially among patients aged 65\u201374 years (detection increased from 0.9% to 1.5%) and \u226585 years (detection increased from 2.9% to 3.3%) during the campaign period. Our findings suggest the feasibility of opportunistic atrial fibrillation screening in routine primary care practice in Japan. Of note, our findings suggest that opportunistic atrial fibrillation screening targeting first-time outpatients may be of clinical value.<\/jats:p>","DOI":"10.1371\/journal.pone.0244240","type":"journal-article","created":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T18:44:23Z","timestamp":1609353863000},"page":"e0244240","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":5,"title":["Acceleration of opportunistic atrial fibrillation screening for elderly patients in routine primary care"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9738-3698","authenticated-orcid":true,"given":"Akifumi","family":"Suzuki","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomonori","family":"Okamura","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Sasaki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hitoshi","family":"Matsuoka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinobu","family":"Ikeda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akira","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5673-7832","authenticated-orcid":true,"given":"Sayako","family":"Akiyama","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fumiko","family":"Ono","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nariaki","family":"Yoshihara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"The Akita Study group","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2020,12,30]]},"reference":[{"key":"pone.0244240.ref001","doi-asserted-by":"crossref","first-page":"837","DOI":"10.1161\/CIRCULATIONAHA.113.005119","article-title":"Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study","volume":"129","author":"SS Chugh","year":"2014","journal-title":"Circulation"},{"key":"pone.0244240.ref002","doi-asserted-by":"crossref","first-page":"1807","DOI":"10.1016\/j.ijcard.2012.12.093","article-title":"Atrial fibrillation: profile and burden of an evolving epidemic in the 21st century","volume":"167","author":"J Ball","year":"2013","journal-title":"Int J Cardiol"},{"key":"pone.0244240.ref003","doi-asserted-by":"crossref","first-page":"1997","DOI":"10.1253\/circj.CJ-66-0092","article-title":"Guidelines for Pharmacotherapy of Atrial Fibrillation (JCS 2013)","volume":"78","author":"JCS Joint Working Group","year":"2014","journal-title":"Circulation J"},{"key":"pone.0244240.ref004","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1001\/archinte.1995.00430050045005","article-title":"Prevalence, age distribution, and gender of patients with atrial fibrillation. Analysis and implications","volume":"155","author":"WM Feinberg","year":"1995","journal-title":"Arch Intern Med"},{"key":"pone.0244240.ref005","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":"GY Lip","year":"2010","journal-title":"Chest"},{"key":"pone.0244240.ref006","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.1001\/archinte.1994.00420130036007","article-title":"Risk Factors for Stroke and Efficacy of Antithrombotic Therapy in Atrial Fibrillation: Analysis of Pooled Data From Five Randomized Controlled Trials","volume":"154","year":"1994","journal-title":"Arch Intern Med"},{"key":"pone.0244240.ref007","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1016\/j.ijcard.2008.06.029","article-title":"Prevalence of atrial fibrillation in the general population of Japan: an analysis based on periodic health examination","volume":"137","author":"H Inoue","year":"2009","journal-title":"Int J Cardiol"},{"key":"pone.0244240.ref008","doi-asserted-by":"crossref","first-page":"983","DOI":"10.1161\/01.STR.22.8.983","article-title":"Atrial fibrillation as an independent risk factor for stroke: the Framingham Study","volume":"22","author":"PA Wolf","year":"1991","journal-title":"Stroke"},{"key":"pone.0244240.ref009","doi-asserted-by":"crossref","first-page":"1760","DOI":"10.1161\/01.STR.27.10.1760","article-title":"Stroke severity in atrial fibrillation. The Framingham Study","volume":"27","author":"HJ Lin","year":"1996","journal-title":"Stroke"},{"key":"pone.0244240.ref010","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.jjcc.2012.12.002","article-title":"Current status of clinical background of patients with atrial fibrillation in a community-based survey: the Fushimi AF registry","volume":"61","author":"M Akao","year":"2013","journal-title":"J Cardiol"},{"key":"pone.0244240.ref011","doi-asserted-by":"crossref","first-page":"1266","DOI":"10.1016\/j.chest.2017.08.004","article-title":"Clinical Impact of Asymptomatic Presentation Status in Patients With Paroxysmal and Sustained Atrial Fibrillation: The Fushimi AF Registry","volume":"152","author":"M Esato","year":"2017","journal-title":"Chest"},{"key":"pone.0244240.ref012","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1093\/ejcts\/ezw313","article-title":"2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS: The task force for the management of atrial fibrillation of the European Society of Cardiology (ESC): Developed with the special contribution of the European Heart Rhythm Association (EHRA) of the ESC: Endorsed by the European Stroke Organization (ESO)","volume":"50","author":"P Kirchhof","year":"2016","journal-title":"Eur J Cardiothorac Surg"},{"key":"pone.0244240.ref013","doi-asserted-by":"crossref","first-page":"383","DOI":"10.1136\/bmj.39280.660567.55","article-title":"Screening versus routine practice in detection of atrial fibrillation in patients aged 65 or over: cluster randomized controlled trial","volume":"335","author":"DA Fitzmaurice","year":"2007","journal-title":"BMJ"},{"key":"pone.0244240.ref014","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1093\/qjmed\/hcw011","article-title":"Opportunistic screening for atrial fibrillation in a rural area","volume":"109","author":"B Smyth","year":"2016","journal-title":"QJM"},{"key":"pone.0244240.ref015","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta9400","article-title":"A randomised controlled trial and cost-effectiveness study of systematic screening (targeted and total population screening) versus routine practice for the detection of atrial fibrillation in people aged 65 and over. The SAFE study","volume":"9","author":"FD Hobbs","year":"2005","journal-title":"Health Technol Assess"},{"key":"pone.0244240.ref016","doi-asserted-by":"crossref","first-page":"e0188086","DOI":"10.1371\/journal.pone.0188086","article-title":"Opportunistic screening for atrial fibrillation in a real-life setting in general practice in Denmark-The Atrial Fibrillation Found On Routine Detection (AFFORD) non-interventional study","volume":"12","author":"J Hald","year":"2017","journal-title":"PLoS One"},{"key":"pone.0244240.ref017","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3310\/hta21290","article-title":"Screening strategies for atrial fibrillation: a systematic review and cost-effectiveness analysis","volume":"21","author":"NJ Welton","year":"2017","journal-title":"Health Technol Assess"},{"key":"pone.0244240.ref018","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1080\/13814788.2017.1374366","article-title":"Screening of older patients for atrial fibrillation in general practice: Current evidence and its implications for future practice","volume":"23","author":"MR Fay","year":"2017","journal-title":"Eur J Gen Pract"},{"key":"pone.0244240.ref019","article-title":"Recommendations for stroke prevention","author":"Take Action for StroKe prevention in AF (TASK-AF) steering committee","year":"2015","journal-title":"2014 version 2"},{"key":"pone.0244240.ref020","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1160\/TH13-02-0165","article-title":"Screening to identify unknown atrial fibrillation","volume":"110","author":"N Lowers","year":"2013","journal-title":"Thromb Haemost"},{"key":"pone.0244240.ref021","article-title":"2017 special report on vital statistic","author":"Ministry of Health, Labour and Welfare","journal-title":"Overview of age-adjusted mortality rates by prefecture in 2015 \u2013leading causes of deaths"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0244240","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,30]],"date-time":"2020-12-30T18:44:48Z","timestamp":1609353888000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0244240"}},"subtitle":[],"editor":[{"given":"Tatsuo","family":"Shimosawa","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2020,12,30]]},"references-count":21,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,12,30]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0244240","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,30]]}}}