Atrial fibrillation (AF) screening was incorporated into an abdominal aortic aneurysm screening (AAA) program for New Zealand (NZ) Māori. AF screening was performed as an adjunct to AAA screening of Māori men aged 60–74 years and women aged 65–74 years registered with primary health care practices in Auckland, NZ. Pre-existing AF was determined through coded diagnoses or medications in the participant’s primary care record. Subsequent audit of the record assessed accuracy of pre-screening coding, medication use and clinical follow-up. Among 1,933 people successfully screened, the prevalence of AF was 144 (7.4%), of which 46 (2.4% of the cohort) were patients without AF coded in the medical record. More than half of these were revealed to be known AF but that was not coded. Thus, the true prevalence of newly detected AF was 1.1% (n=21). An additional 48 (2.5%) of the cohort had been coded as AF but were not in AF at the time of screening. Among the 19 at-risk screen-detected people with AF, 10 started appropriate anticoagulation therapy within 6 months. Of the nine patients who did not commence anticoagulation therapy, five had a subsequent adverse clinical outcome in the follow-up period, including one with ischaemic stroke; two had contraindications to anticoagulants. Among those with previously diagnosed AF, the proportion receiving anticoagulation therapy rose from 57% pre-screening to 83% at 6 months post-screening (p<0.0001); among newly diagnosed AF the proportion rose from 0% to 53% (p<0.01). AF screening is a feasible low-cost adjunct to AAA screening with potential to reduce ethnic inequities in stroke incidence. However, effective measures are needed to ensure that high-risk newly diagnosed AF is managed according to best practice guidelines.

中文翻译：

---

通过腹主动脉瘤筛查计划发现新西兰毛利人心房颤动的患病率和治疗

心房颤动 (AF) 筛查已纳入新西兰 (NZ) 毛利人的腹主动脉瘤筛查 (AAA) 计划。房颤筛查是作为 AAA 筛查的辅助手段，对新西兰奥克兰初级卫生保健机构注册的 60-74 岁毛利男性和 65-74 岁女性进行的。预先存在的房颤是通过参与者初级保健记录中的编码诊断或药物来确定的。随后对记录的审核评估了预筛选编码、药物使用和临床随访的准确性。在成功筛查的 1,933 人中，房颤患病率为 144 人（7.4%），其中 46 人（占队列的 2.4%）是病历中没有编码的房颤患者。其中超过一半被发现是已知的 AF，但并未进行编码。因此，新检测到的 AF 的真实患病率为 1.1% (n=21)。该队列中另有 48 人 (2.5%) 被编码为 AF，但在筛查时并未处于 AF 状态。在 19 名筛查出患有 AF 的高危人群中，有 10 人在 6 个月内开始了适当的抗凝治疗。在未开始抗凝治疗的 9 名患者中，有 5 名患者在随访期间出现不良临床结果，其中一名患有缺血性中风；两人有抗凝剂禁忌症。在既往诊断为 AF 的患者中，接受抗凝治疗的比例从筛查前的 57% 上升至筛查后 6 个月的 83% (p<0.0001)；在新诊断的 AF 中，这一比例从 0% 上升至 53% (p<0.01)。 AF 筛查是 AAA 筛查的一种可行的低成本辅助手段，有可能减少中风发病率的种族不平等。然而，需要采取有效措施，确保根据最佳实践指南对新诊断的高风险房颤进行管理。