Hidden Beats: Detection of Subclinical Atrial Fibrillation Using Questionnaires in Young Adults and Its Cardiovascular Risk Profile

Objectives: The objectives were to identify subclinical AF in young individuals and to examine its association with cardiovascular risk profile and quality of life (QoL) in a young adult cohort. Design: A cross-sectional survey was conducted with 403 adults aged 18-40 years in public and private hospitals. Methods: The INTERHEART Modifiable Risk Score (IHMRS), Atrial Fibrillation Effect on Quality-of-Life (AFEQT) questionnaire, and the Modified European Heart Rhythm Association (mEHRA) were used to collect data. The statistics were performed using descriptive statistics, Spearman's correlation, the Mann-Whitney U test, the Kruskal-Wallis test, and multiple linear regression in IBM SPSS 26. Results: Of the 403 respondents, the majority were male (85%) and aged 36-40 (30%). A stronger negative correlation with QoL (0.42, p < 0.001) and a weaker positive correlation with cardiovascular risk (0.13, p = 0.009) were observed between higher EHRA symptom severity and cardiovascular risk. There was also a negative correlation between QoL and IHMRS (r = -0.29, p = < 0.001). Women presented with greater symptoms and low QoL (p < 0.001). The regression analysis showed that predictors of better IHMRS were age, male gender, higher EHRA scores, physical inactivity, and a family history of CVD. In contrast, better QoL was a protective factor (p < 0.01). Conclusions: Subclinical AF symptoms were highly correlated with increased cardiovascular risks and decreased QoL in young adults. Early detection of high-risk individuals, especially in settings with limited resources, could be achieved through simple questionnaire-based screening.