High Prevalence of Atrial Fibrillation Found in the Capital of Greenland When Using Continuous Electrocardiogram Monitoring: A Cross-Sectional Study

• Published in: CJC open (Online) 2024-07, Vol.6 (7), p.884-892
• Main Authors: Albertsen, Nadja, Jensen, Mads Mose, Hansen, Kunuk Lauge Koch, Pedersen, Michael Lynge, Andersen, Stig, Brock, Christina, Riahi, Sam
• Format: Article
• Language: English
• Subjects: Arrhythmias and Electrophysiology
• ISSN: 2589-790X; 2589-790X
• DOI: 10.1016/j.cjco.2024.03.011

Atrial 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 prevalences of AF risk factors are increasing. Studies based on 30-second electrocardiograms (ECGs) and diagnosis codes so far have indicated either a low prevalence of AF or a prevalence comparable to that in 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. In this cross-sectional study, we estimated the prevalence of AF among the population aged ≥ 50 years in Greenland’s capital, Nuuk. We used an ePatch to record continuous ECGs for 3-5 days, and questionnaires to assess demographic data, comorbidities, medication, symptoms, and risk factors for AF. Of 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% (confidence interval [CI] 5.8-13.9). The age-stratified prevalence was 7.2% (CI 2.7-15.1) among those aged 50-59 years; 8.8% (CI 4.1-16.1) among those aged 60-69 years; and 18.2% (CI 7.0-35.5) among those aged ≥ 70 years. This 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. La fibrillation auriculaire augmente le risque d’accidents vasculaires cérébraux (AVC) ischémiques, de démence et d’insuffisance cardiaque. Il est donc essentiel de la dépister rapidement. Au Groenland, les AVC ischémiques sont fréquents, et la prévalence des facteurs de risque de fibrillation auriculaire est à la hausse. Les études reposant sur des électrocardiogrammes (ECG) de 30 secondes et des codes de diagnostic ont jusqu’à présent révélé une faible prévalence de la fibrillation auriculaire ou une prévalence comparable à celle d’autres pays occidentaux, comme le Danemark. Cependant, l’utilisation d’ECG courts à un moment fixe dans le temps peut sous-estimer la prévalence réelle, car la fibrillation auriculaire paroxystique, en particulier, peut passer inaperçue. Cette étude a pour but d’estimer la prévalenc