As one of the most common forms of abnormal heart rhythm, and a major cause of stroke, atrial fibrillation must be propelled to the frontlines of public concern. Help empower patients and provide them with a multi-faceted approach for both the management and prevention of the condition.

What is Atrial Fibrillation?

Atrial fibrillation, or AF, is the most common type of irregular heart rhythm. It causes an irregular and often abnormally fast heart rate.

Northern Ireland in the Spotlight

Local health charity Northern Ireland Chest Heart and Stroke (NICHS) commissioned an independent opinion survey in October 2018 and found that, worryingly, only 30 people in every 100 had heard of AF and knew that it may increase your risk of stroke by five times.

Of the 30 per cent of the population who had heard of AF:

• Over a quarter didn’t know about the increased risk of stroke

• Nearly 10 per cent wrongly thought that having AF does not increase your risk of stroke

Over 40,000 local people have been diagnosed as having AF, although it is estimated that thousands more are living with the condition undetected.

What are the Symptoms of AF?

As outlined by NICHS, sometimes people with AF have no symptoms and their condition is only detectable during a medical examination.

Some people may experience one or more of the following symptoms:

• Feeling very tired

• Feeling faint at times

• Being breathless

• Palpitations or fluttering or ‘thumping’ in the chest

How Can AF Increase Your Patient’s Chance of a Stroke?

If the individual’s heart doesn’t have a regular heartbeat, it may not empty its chambers of blood at each beat. A clot could form in the blood left behind, which can then travel to the brain and cause a stroke.

People with AF are likely to have a much more severe stroke with:

• Almost double the death rate from a stroke

• Increased disability from a stroke

• Longer hospital stays

• Increased risk of a stroke happening again

How will AF Affect their Daily Life?

With the right treatment plan for AF, your patient can live a long and healthy life. Treatment plans for AF have two aims – to reduce the risk of a stroke and to manage the day-to-day symptoms and effects of AF.

In addition to taking their medication, you should discuss with the patient the importance of – and how they must aim to have – a healthy lifestyle.

AF and Treatment

For patients diagnosed with AF, a treatment plan should be devised for them with two aims – to reduce their risk of a stroke, and to bring the rate and rhythm of their heart under control.

Preventing a Stroke

Patients should be advised of the importance of working with their doctor to reduce stroke risk, and to make sure that they have a good prognosis with AF. They may be prescribed anti-coagulant medicines to reduce the risk of blood clot formation. It is important that they take the medication exactly as prescribed in order to reduce their risk of a stroke.

Controlling the Patient’s Heart Rate and Heartbeat

There are three potential treatments which may be carried out for the symptoms of AF, to try to restore the patient’s heart to a normal rhythm:

1. Prescribe medication – this will aim to control the rate and rhythm of the heartbeat

2. Cardio-version – this is a treatment where electrical signals are sent to the heart through electrodes placed on the chest

3. Ablation – this treatment uses heat or freezing on the area of the individual’s heart that is causing the abnormal heart rhythm

AF and Prevention

The cause of AF is not fully understood but there are certain factors that can increase the risk of developing it. For example, certain health conditions including heart failure, high blood pressure or other cardiovascular diseases, diabetes or thyroid disorders can increase an individual’s risk. Also, a family history of AF may play a role; and as people get older, the development of the condition may be more likely.

However, while the risk of developing AF increases with the above-mentioned factors, many people develop AF for no explainable reason. However, there are lifestyle changes that can be suggested to the public to help prevent AF and these include the following:

• Moderate their alcohol intake

• Eat a balanced diet

• Keep physically active

• Watch their weight

• Manage their stress levels

• Get enough sleep

Public Awareness

NICHS have been running a campaign, supported by MACE, aimed at raising awareness that AF is a serious illness in Northern Ireland.

NICHS have pushed their message out to the public through billboards and bus shelter ads, radio ads, posters in GP surgeries, pharmacies and libraries. The campaign was supported by local retailer MACE, who displayed posters in their stores, included AF information on the leaflets they sent out to the public, and had AF testing for customers in selected stores.

NICHS has more information including two leaflets that can be downloaded from their website: www.nichs.org.uk.