The incidence of atrial fibrillation (AF) has been younger in recent years and AF seriously threatens human survival and health. Based on the decision tree-Markov model, the natural development process of AF-stroke-disease outcome was simulated, and the health economics evaluation of different atrial fibrillation screening strategies was carried out according to the indicators of cost and utility. Different optimal screening combination strategies were proposed according to the level in Shanghai and domestic average. Further sensitivity analysis indicated that the cost-effectiveness sensitivity of AF screening cost was the most significant in Shanghai, but the cost of anticoagulant treatment was the most sensitive to the cost utility of the domestic average. Finally, in order to better carry out health management of AF, some suggestions on AF screening strategies were put forward, which provided a reference for the optimization of health management mode of AF screening and prevention in our country.