A Campaign for Information and Diagnosis of Atrial Fibrillation: “Pulse Week”

Introduction and objectivesAtrial fibrillation occurs in 5%-15% of elderly patients and causes one-fourth to one-fifth of all cerebrovascular events. These patients are frequently asymptomatic. We conducted a public campaign aiming to evaluate the effectiveness of a program for information on and diagnosis of atrial fibrillation in individuals aged 65 years old or more from the primary care perspective.MethodsWe sent letters containing informative materials and an invitation to attend a special nurse appointment to all individuals≥65 years old, without a previous diagnosis of atrial fibrillation or flutter. Patients were from 3 specific areas in Pontevedra province. The procedures were performed according to a specially designed program called “Pulse Week” within 5 working days. A group of trained nurses obtained a brief medical history and performed pulse palpation for 15 s and blood pressure measurement. A complete 12-lead electrocardiogram was performed if arrhythmic pulsations were detected.ResultsA total of 8869 letters were sent. During the specified week, 1532 individuals were evaluated (877 women); the mean age was 72.5 (6.5) years old, 833 had hypertension (54%), 232 had diabetes (15%), 61 had previous stroke (4%) and 88 had had a myocardial infarction (6%). Electrocardiograms were performed in 187 patients. There were 17 patients with newly diagnosed atrial fibrillation.ConclusionsA public, 5-day campaign based on pulse palpation and targeting elderly individuals had little impact on the detection of new cases of atrial fibrillation in our environment.

ResumenIntroducción y objetivosLa fibrilación auricular está presente en un 5-15% de la población anciana y causa una quinta o una cuarta parte de los accidentes cerebrovasculares. No es infrecuente que estos pacientes estén asintomáticos. Realizamos una campaña pública con el objetivo de evaluar la efectividad de un programa de información y diagnóstico de la fibrilación auricular en personas de 65 años o más desde el ámbito de la atención primaria.MétodosSe envió una carta con un díptico informativo y una invitación para acudir a consulta a todos los individuos de 65 años o mayores sin diagnóstico previo de fibrilación o flutter auricular de tres áreas concretas de la provincia de Pontevedra. Las consultas se efectuaron dentro de un programa especial denominado «Semana del Pulso», durante 5 días laborables, en el que un grupo de enfermeras entrenadas realizaba una breve historia clínica, palpación del pulso durante 15 s y estimación de la presión arterial. Si el pulso era arrítmico, se realizaba un electrocardiograma de 12 derivaciones.ResultadosSe enviaron 8.869 cartas. Durante la semana especificada acudieron 1.532 sujetos (877 mujeres) con una media de edad de 72,5 ± 6,5 años, 833 (54%) con historia de hipertensión arterial, 232 (15%) diabéticos, 61 (4%) con ictus previo y 88 (6%) con infarto de miocardio antiguo. Se realizaron 187 electrocardiogramas por pulso arrítmico. Se detectó fibrilación auricular previamente no conocida en 17 pacientes (1%).ConclusionesUna campaña dirigida a población anciana, basada en la palpación del pulso durante 5 días de consultas, tiene escasa capacidad para detectar nuevos casos de fibrilación auricular en nuestro medio.