Understanding and treating the crisis of atrial fibrillation

Atrial fibrillation is a huge strain on healthcare services, but life-changing treatments are fighting this trend. 

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Atrial fibrillation (AF), is an irregular and often fast heartbeat that results in uncoordinated contraction of the top two chambers of the heart. It is fast becoming one of the world’s most significant health issues, placing a critical burden on healthcare systems, with the potential to cause devastating consequences for patients.

AF is the most common type of heart arrhythmia and over one million people suffer from the condition in the UK alone. Estimates indicate that by 2030, the number of patients with atrial fibrillation in Europe will be between 14–17m, with 120,000–215,000 new cases per year.

Awareness of treatment options for AF is low, with patients often under-diagnosed and/or referred too late.

Research shows that some patients do not recognize the symptoms of AF, typically leading to a four to five year delay before a diagnosis. There is also a critical misconception regarding the seriousness of atrial fibrillation, as based on an international survey: 50 per cent of patients believe AF is not a life-threatening condition.

What’s more, patients with AF have an increased risk of life-threatening complications and other diseases:

  • 5x increase in heart failure
  • 2.4x increase in stroke
  • 2x increase in cardiovascular mortality

Lifestyle factors, such as obesity or high alcohol consumption, other health conditions such as diabetes and high blood pressure and nonadjustable factors such as old age or genetics are all contributors that can lead to AF.

As well as causing a devastatingimpact on patients, the direct costs for AF are high for healthcare systems, with it accounting for 0.9 per cent – 2.4 per cent of total annual healthcare expenditures in the UK.

By 2050, Europe is projected to have the greatest number of AF patients compared to other regions globally. This is expected to increase the number of stroke events, hospitalisations, and doctor visits, ultimately raising the cost to national healthcare systems.

We are committed to delivering solutions that help clinicians reach more patients and heal more hearts, and for over 20 years we have pioneered the development of atrial fibrillation ablation treatment. It is estimated that only 4 per cent of atrial fibrillation patients undergo ablation treatment, with many relying on medication. We believe ablation treatment is crucial to tackling AF, which is fast becoming the new millennium epidemic.

Alison James is the business leader at Biosense Webster Inc. UK & Ireland.

 

Atrial fibrillation perspectives 

Syed Ahsan, consultant cardiologist, St Bartholomew’s Hospital

Atrial fibrillation is a common problem in people over 65. It causes irregular heart rhythms, which in some cases can lead to debilitating strokes and even mortality. 

The guidelines in the UK dictate that patients suffering from atrial fibrillation should be placed on anti-arrhythmic medication in the first instance. In our experience, we find that medication works for some patients, but it can also cause side effects, and for a lot of patients it can even cease to be effective after an extended period of time. When medication proves ineffective, we move onto a catheter ablation.

A catheter ablation is a procedure that can be used for different types of heart rhythm abnormalities, but heart palpitations is by far the most common condition that we are treating with this procedure at the moment. It uses a fine wire to deliver a high-speed frequency to treat the abnormal signals causing the palpitations. The wire is administered through the patient’s groin, and up through the ephemeral vein which runs like a motorway to the heart.  

There’s now a huge drive to try and screen patients, particularly over 65s, who often aren’t aware of the abnormality but are most likely to suffer from it. Our detection and treatment rates are certainly going to increase significantly as a result of this, and the technology has evolved so much over the last two years that we’re looking at success rates approaching the 80 to 90 per cent mark. We’re even getting patients coming to us now and asking us for an ablation. 

Training to become a cardiologist takes about six years, and atrial fibrillation falls under a sub-speciality called arrhythmia, or heart rhythm management, which is a long but very rewarding process. It’s very satisfying to see the positive effects of this procedure on patients.  

 

Trudie Lobban, founder and CEO, Arrhythmia Alliance & AF Association

Knowing your pulse can save your life; if pulse checks were routine within the NHS, thousands of lives, and thousands of debilitating AF-related strokes, could be saved every year. The easiest way to detect an arrhythmia is to know the pulse to feel your heart rhythm: uneven, too fast, or too slow?

One of the easiest places to feel your pulse is on your wrist, just below your thumb. You can feel your pulse in other areas of your body including your neck, in your groin or behind your knee.

It is a good idea to try taking your pulse at various points throughout the day (before and after different physical activities). Your pulse rate and rhythm will change depending on what activity you are doing – this is normal. To check your baseline pulse and normal rhythm, try taking your resting pulse when you wake in the morning and before going to bed.

A normal pulse is between 60 and 100 beats per minute, but there are normal reasons why your pulse may be slower or faster. This may be due to age, medication, caffeine, fitness level, other illnesses including a heart condition, stress or anxiety. Although your pulse rate may be within a normal range, it may not be regular.

You should seek further advice if you experience the following:

  • If your pulse seems to be racing some or most of the time and you are feeling unwell.
  • If your pulse seems to be slow some or most of the time and you are feeling unwell.
  • If your pulse feels irregular, even if you do not feel unwell.
  • If your heart rate is generally slow or fast and/or your heart rhythm is irregular, you should speak to your healthcare professional.