BACKGROUND Detection and treatment of atrial fibrillation (AF) are important given the serious health consequences. AF may be silent or paroxysmal and remain undetected. It is unclear whether general practitioners (GPs) have appropriate equipment and optimally utilise it to detect AF. This case vignette study aimed to describe current practice and to explore possible improvements to optimise AF detection. METHODS Between June and July 2017, we performed an online case vignette study among Dutch GPs. We aimed at obtaining at least 75 responses to the questionnaire. We collected demographics and asked GPs' opinion on their knowledge and experience in diagnosing AF. GPs could indicate which diagnostic tools they have for AF. In six case vignettes with varying symptom frequency and physical signs, they could make diagnostic choices. The last questions covered screening and actions after diagnosing AF. We compared the answers to the Dutch guideline for GPs on AF. RESULTS Seventy-six GPs completed the questionnaire. Seventy-four GPs (97%) thought they have enough knowledge and 72 (95%) enough experience to diagnose AF. Seventy-four GPs (97%) could order or perform ECGs without the interference of a cardiologist. In case of frequent symptoms of AF, 36-40% would choose short-term (i.e. 24-48 h) and 11-19% long-term (i.e. 7 days, 14 days or 1 month) monitoring. In case of non-frequent symptoms, 29-31% would choose short-term and 21-30% long-term monitoring. If opportunistic screening in primary care proves to be effective, 83% (58/70) will support it. CONCLUSIONS Responding GPs report to have adequate equipment, knowledge, and experience to detect and diagnose AF. Almost all participants can order ECGs. Reported monitoring duration was shorter than recommended by the guideline. AF detection could improve by increasing the monitoring duration.

中文翻译：

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荷兰全科医生如何检测和诊断房颤？在线案例研究的结果。

背景技术鉴于严重的健康后果，房颤（AF）的检测和治疗非常重要。AF可能是沉默的或阵发性的，并且未被检测到。目前尚不清楚全科医生（GP）是否具有适当的设备，并可以最佳地利用它来检测房颤。本案例插图研究旨在描述当前的做法，并探索可能的改进以优化AF检测。方法在2017年6月至2017年7月之间，我们对荷兰全科医生进行了在线案例研究。我们旨在获得至少75份对问卷的答复。我们收集了人口统计资料，并询问了全科医生对他们诊断房颤的知识和经验的意见。GP可以指出他们拥有哪些用于AF的诊断工具。在六种具有不同症状频率和生理症状的小插曲中，他们可以做出诊断选择。最后一个问题涉及诊断房颤后的筛查和行动。我们将答案与荷兰关于房颤的GP指南进行了比较。结果76名全科医生完成了问卷调查。74名GP（97％）认为他们具有足够的知识和72（95％）的经验可以诊断AF。七十四名全科医生（97％）可以订购或执行ECG，而无需心脏病专家的干预。如果出现频繁的AF症状，则36-40％的患者会选择短期（即24-48小时），而11-19％的患者会选择长期（即7天，14天或1个月）监测。如果是非经常性症状，则29-31％的人会选择短期监测，而21-30％的人会选择长期监测。如果事实证明在初级保健中进行机会性筛查是有效的，则83％（58/70）的人会对此予以支持。结论响应的GP报告具有足够的设备，知识和经验来检测和诊断AF。几乎所有参与者都可以订购ECG。报告的监测持续时间短于该指南的建议。自动对焦检测可以通过增加监视持续时间来改善。