USPSTF Doesn't Endorse Routine ECG for Atrial Fibrillation Detection or CVD Prevention

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Lorenzo Di Francesco, MD, FACP, FHM

The U.S. Preventive Services Task Force does not endorse electrocardiography (ECG) screening to detect atrial fibrillation or to prevent cardiovascular disease events in a pair of draft recommendation statements.

In one statement, the USPSTF says there is not enough evidence to make a recommendation for or against screening asymptomatic seniors for atrial fibrillation with ECG (grade I statement). There were not enough data to determine whether ECG is better than opportunistic screening or usual care at detecting atrial fibrillation in older adults. In addition, screening is associated with small-to-moderate harms, such as misdiagnosis and overtreatment. This is the group's first statement on this topic.

In a separate statement, the task force recommends against screening with resting or exercise ECG to prevent CVD events in low-risk, asymptomatic adults (grade D). But the group concludes that evidence is lacking to make a determination for or against such screening in adults with intermediate or high risk (grade I). These are in line with the group's 2012 recommendations.