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Screening results

ECG results

Systematic screening results

Consider repeated screening

No definite AF but symptoms or high risk

of AF or high risk of ischaemic stroke

(CHA2DS2-VASc score >1 in men or >2 in women with diabetes)

Suspicion of AF

Atrial fibrillation confirmed No atrial fibrillation 12-lead ECG

Symptomatic patient e.g. palpitations, dyspnoea

Asymptomatic patient

Opportunistic screening (e.g. pulse palpation, ECG)

(Class I) Yearly opportunistic

screening

Systematic screening: repeated surface ECG, Holter ECG, patient-activated or wearable device

Start treatment with OAC (NOACs preferred over VKA) According to CHA2DS2-VASc score

Screening and treatment of AF in patients with diabetes by healthcare professionals

Negative

Negative

Negative

Positive

Positive

Positive

Figure 17 Screening for atrial fibrillation in patients with diabetes. AF, atrial fibrillation; CHA2DS2-VASc, Congestive heart failure, Hypertension, Age ≥75 years (2 points), Diabetes mellitus, Stroke or transient ischaemic attack (2 points), Vascular disease, Age 65–74 years, Sex category (female); ECG, electrocardiogram; OAC, oral anticoagulant; NOAC, non-vitamin K antagonist oral anticoagulant; VKA, vitamin K antagonist.

ESC Guidelines                                                                                                                                                                                          4097

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