Background: Atrial fibrillation (AF) is the most common arrhythmia, with more than 100 000 confirmed cases in Norway. A feared complication of AF is ischemic stroke. About 15% of ischemic strokes can be directly linked to clinical AF, while over 25% are cryptogenic and without any known cause. AF can present with typical symptoms, but several recent studies have shown that up to 40% of patients have no symptoms at all, and that a part of the cryptogenic strokes may be caused by an asymptomatic and unknown AF. There are no studies concluding that asymptomatic AF has better outcomes than symptomatic, and ischemic stroke may be a feared and acute presenting symptom of the AF in this group. Use of oral anticoagulants reduces the risk of stroke with 64-70 %, but undertreatment is a clinical problem, knowing that AF often is asymptomatic and underdiagnosed. Considering the high prevalence of AF, the great portion of people at an asymptomatic stage, that we have a well-documented treatment for clinical AF and different options for diagnostics, it should be discussed if AF is a potential candidate for systematic screening in Norway in order to reduce the number of ischemic strokes. Methods: For this review, we used PubMed to find studies evaluating the effect of a systematic screening programme for atrial fibrillation. Results: 29 studies (6 RCTs, 14 observational studies and 9 systematic reviews) were included. Most of them showed that systematic screening identifies people with undiagnosed AF with high stroke risk, especially in the older age groups. Several diagnostic tools are available with high sensitivity and specificity and seem acceptable to the participants. Only handheld devices permit intermittent ECG recordings. Conclusions: Systematic screening for AF in the elderly patients, e.g. ≥ 75 years, with handheld ECG-devices is feasible and identifies people with undetected AF who most likely will benefit from anticoagulant treatment. A large ongoing RCT in Sweden may answer whether such screening also improves clinical outcome in these patients.