High prevalence of atrial fibrillation found in the capital of Greenland when using continuous ECG monitoring: a cross-sectional study

Abstract

BackgroundAtrial fibrillation (AF) increases the risk of conditions such as ischemic stroke, dementia and heart failure, and early detection is crucial. In Greenland, ischemic strokes are common, and the prevalence of AF risk factors are increasing. Studies based on 30-second ECGs and diagnosis codes have so far indicated either a low prevalence of AF or a prevalence comparable to other Western countries, such as Denmark. However, using short, single-point ECGs may underestimate the true prevalence, as especially paroxysmal AF can be missed. With this study, we aim to estimate the prevalence of AF using 3–5-day continuous Holter recordings among people in Nuuk, the capital of Greenland. MethodsIn this cross-sectional study, we estimated the prevalence of AF among the population aged 50 years and older in Greenland’s capital, Nuuk. We used an ePatch to record continuous ECGs for three to five days, and questionnaires to assess demographic data, comorbidities, medication, symptoms, and risk factors for AF. ResultsOf 226 participants (62% women), 21 (33% women) had either self-reported AF, AF on the recording or both, equivalent to a prevalence of 9.3% (CI 5.8-13.9). The age-stratified prevalence was 7.2% (CI 2.7-15.1) among the 50-59-year-olds, 8.8% (CI 4.1-16.1) among the 60-69-year-olds and 18.2% (CI 7.0-35.5) among the 70+ year-olds. ConclusionThis study provides a novel insight into AF prevalence in Nuuk, emphasizing the potential underestimation in previous studies. Continuous ECG monitoring revealed a higher prevalence, especially among the younger age groups, urging a reevaluation of diagnostic practices in this unique population.