Background: The frequent asymptomatic presentation of atrial fibrillation (AF) may delay stroke-prophylaxis with anticoagulation therapy. In this thesis, the concurrence of AF diagnosis with ischaemic stroke and the performance of two potential screening methods were evaluated. 

Methods: 1) Altogether, 3,623 AF patients treated for their first ischaemic cerebrovascular event were assessed from patient records. 2) The capability of 173 elderly subjects to assess cardiac rhythm by pulse palpation was assessed using a programmable anatomic model-arm. 3) Altogether, 205 elderly subjects instructed to palpate their pulse twice-daily and seek immediate medical attention if irregularity is noticed were followed for three years to record new AF diagnoses. 4) Three-minute smartphone-mechanocardiography recordings were obtained from 150 subjects in AF and 150 subjects in sinus rhythm (SR) (confirmed with simultaneous electrocardiography), after which an automated algorithm determined the rhythm during each recording. 

Results: 1) AF was detected concurrently with the ischaemic cerebrovascular event in 753 (20.8%) patients. 2) Of the 148 (85.5%) subjects who reliably found the pulse, 97.3% identified SR, 81.8% slow AF, 91.9% fast AF and 74.3% SR with ventricular extrasystoles. 3) After 36 months, only 69 (33.7%) subjects palpated their pulse at least weekly, and only 1 new AF diagnosis was made due to pulse irregularity during three years. 4) Mechanocardiography demonstrated 95.3% sensitivity and 96.0% specificity to detect AF. 

Conclusions: AF and stroke are frequently diagnosed concurrently. The elderly accurately distinguish SR by pulse palpation, but insufficient long-term motivation limits screening by pulse self-palpation. Smartphone mechanocardiography seems to reliably detect AF without additional hardware.