ESC Congress 2026 Abstract · Oct 26, 2026
Incidental findings of ventricular tachycardia in a nationwide atrial fibrillation screening trial: Insights from the NORSCREEN trial
By Haraldsen M, Boskovic M, Berge T et al.
Background/Introduction: The widespread implementation of long-term ECG monitoring for atrial fibrillation (AF) screening may uncover incidental arrhythmias, most notably non-sustained ventricular tachycardia (NSVT). While the prognostic impact of NSVT is well-established in patients with overt cardiovascular disease, its prevalence and clinical determinants in an unselected screening population remain largely unexplored. Purpose: To determine the prevalence and clinical determinants of NSVT in a large-scale, nationwide AF screening cohort. Methods: The ongoing Norwegian AF Self-Screening trial (NORSCREEN) enrolled 50,549 individuals aged ≥65 years with ≥1 additional stroke risk factor and no prior history of AF or anticoagulation therapy. Participants underwent 7 days of continuous single-lead ECG monitoring using the ECG247 patch system (Figure 1). All recordings were processed by an automated algorithm, followed by manual verification by a cardiologist. NSVT was defined as ≥4 consecutive ventricular beats at a rate ≥100 bpm, lasting <30 seconds. Results: Of 25,264 participants randomized to screening (median age 75 years [IQR 69-78], 46.4% female), 19,723 completed the screening procedure. Median ECG monitoring duration was 7.2 days [IQR 5.2-7.9], with 52.0% monitored for ≥7 days. Incidental NSVT was detected in 824 (4.2%), with a median episode duration of 3 seconds [IQR 2-5]. The prevalence of NSVT was higher in men than in women (5.9% vs 2.1%, p<0.001), with no significant age difference between individuals with and without NSVT. Participants with NSVT more frequently had prior myocardial infarction (12.3% vs 8.2%, p<0.001), heart failure (3.1% vs. 1.7%, p<0.001), and current smoking (8.0% vs 5.8%, p<0.001). No significant differences were observed for hypertension (65.5% vs 67.1%, p=0.32), chronic obstructive pulmonary disease (4.8% vs 4.6%, p=0.76), or diabetes (11.3% vs 13.4%, p=0.08). In multivariable logistic regression, male sex (adjusted odds ratio [aOR] 2.9, 95% CI 2.4–3.4), heart failure (aOR 1.6, 95% CI 1.1–2.6), and current smoking (aOR 1.4, 95% CI 1.0–1.9) independently predicted the presence of NSVT (Figure 2). Conclusions: In this large-scale, nationwide screening trial, incidental NSVT was detected in 4.2% of participants. NSVT was associated with male sex, heart failure and current smoking. The prognostic significance and clinical implications of these findings warrant further investigation. Figure 1:A) Representative ECG tracing from the ECG247 patch-based ECG system showing a non-sustained ventricular tachycardia (NSVT). B) Prevalence of NSVT stratified by age. Figure 2: Association between baseline characteristics and the probability of non-sustained ventricular tachycardia (NSVT).Figure 1Figure 2