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ISSN: 1734-3402
Family Medicine & Primary Care Review
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2/2024
vol. 26
 
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abstract:
Original paper

Occurrence of asymptomatic atrial fibrillation in non-ambulatory patients: a retrospective study in primary care setting

Gabriele Poti
1
,
Francesca Sparano
2
,
Giovanna Cataldo
3
,
Silvestro Scotti
4
,
Pasquale Izzo
5
,
Stefano Calamaro
6
,
Luigi Sparano
7
,
Carmine Sellitto
8

  1. General Practitioner and Business Council ASL Naples 1, Italy
  2. School of Medicine, University of Plovdiv, Plovdiv, Bulgaria
  3. Department of Mental and Physical Health and Preventive Medicine, Section of Human Anatomy, University of Campania “Luigi Vanvitelli,” Naples, Italy
  4. National Secretary, Italian Federation of General Practitioners, Rome, Italy
  5. Director U.O.C. Primary Care, ASL Naples 1, Italy
  6. General Practitioner, ASL Naples 1, Italy
  7. Board of the Italian Federation of General Practitioners, Naples, Italy
  8. Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, Unit of Pharmacology, University of Salerno, Baronissi, Italy
Family Medicine & Primary Care Review 2024; 26(2): 228–230
DOI: https://doi.org/10.5114/fmpcr.2024.139034
Online publish date: 2024/06/17
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Background
Atrial fibrillation (AF) is a common cardiac rhythm disease identified in clinical practice. AF patients often suffer heart-pounding, dyspnea, chest pain, and fatigue, while others with AF have no symptoms, showing the so-called silent or asymptomatic AF. General Practitioners (GPs), through home visits, may meet unrecognized pathologies, such as asymptomatic AF, in at-risk populations like non-ambulatory patients. The purpose of the study is to identify the occurrence of asymptomatic AF in a population of frail non-ambulatory patients in the primary care setting and to promote a good clinical practice regimen.

Material and methods
A retrospective observational study, which enrolled patients in the primary care setting of the city of Naples, was conducted. The patients were all non-ambulatory and were visited at home by their GPs. They performed a clinical examination at the patients’ homes, including clinical and pharmacologic anamnesis, objective examination, echo-color Doppler of the supra-aortic vessels, electrocardiogram, 24-Hour Holter monitoring, and abdominal ultrasound.

Results
The study enrolled 100 non-ambulatory patients, aged 80 to 94 years, including 61 women and 39 men. In 35 patients (21 women and 14 men), the GPs identified asymptomatic AF.

Conclusions
Asymptomatic atrial fibrillation was identified in 35% of the study population. This should be considered in at-risk populations, such as the non-ambulatory patients. GPs, by conducting home visits with basic instrumental examinations, can help to identify asymptomatic AF and start the right diagnostic and therapeutic course in these patients.

keywords:

atrial fibrillation, general practitioners, primary health care

  
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