Atrial fibrillation (AF) is a type of irregular heart rhythm, or arrhythmia, which increases the risk of stroke, known as an AF-related stroke, which are more debilitating than other forms of stroke. We can protect ourselves by knowing our own heart rhythm.
Over 500,000 people in the UK currently have undiagnosed AF. Its symptoms can include palpitations, pounding heart, and fainting, and it causes a 5% annual increase in the risk of an AF-related stroke.
Yet it can easily be identified through a manual pulse rhythm check, and verified with a handheld mobile ECG device. Though we are all used to having our blood pressure checked when we go to a doctor or feel unwell, many of us may not realise that the heart rate is not the same as the heart rhythm.
“A doctor used to feel your pulse manually and have a stethoscope to listen to your heart’s rhythm,” says Trudie Lobban, CEO and Founder of Arrhythmia Alliance (A-A), which campaigns for heart rhythm to be checked routinely through a simple manual pulse rhythm check. “Now the automatic blood pressure machines tell the doctor or nurse the heart rate, but not the rhythm.”
It is an important distinction, she says, because familiarity with the heart’s rhythm is the easiest, cheapest and quickest way to detect AF early and protect against stroke.
“All too often, people end up in A&E with a stroke and only then is the AF diagnosed. If they had received an early diagnosis and appropriate therapy, they could have avoided the stroke and be leading normal lives.”
Therapy and Treatment – the difference
Once detected, AF needs therapy through anti-coagulation to prevent an AF-related stroke, and treatment to manage symptoms and the heart rhythm. This may be done by drugs or techniques such as ablation or cardioversion.
Many patients are still incorrectly given aspirin as an anti-coagulant therapy, but this is now proven not to work on its own in preventing an AF-related stroke.
Be aware at all ages
AF incidence increases with age: 1 in 4 people over 65 will develop the condition. It’s never too early to start getting familiar with your own pulse so that you can sense when something is not right, says Lobban.
“We go into schools to teach children about this, and their homework is to go home and check their parents’, neighbour’s or grandparents’ pulses. Two children recently noticed irregularities in their fathers’ pulses and were diagnosed with arrhythmia as a result.”
You can learn online how to monitor your pulse. If you’re having symptoms, check it immediately, otherwise, once a week is fine, says Lobban. If you notice irregularities – whether or not you’re having symptoms – make an appointment to see your GP.
A-A is calling for a four-step management pathway for all patients with AF:
- Detect the abnormal rhythm with a simple manual pulse rhythm check
- Protect against AF-related stroke through anticoagulation (not aspirin)
- Correct the abnormal heart rhythm
- Perfect the patient care pathway
Lobban advises people to take notes into the appointment, and engage with the doctor or nurse when you are there – ask them to take your pulse. “We should be a nation that knows about its heart rhythm.”