It is described as a potential ticking time bomb.
Atrial fibrillation – an irregular heart beat causing abnormalities in the rhythm of the heart putting patients at risk of sudden, cardiac arrest, heart attack or stroke, affects around 800,000 people in the UK.
According to the Stroke Association, about a quarter of people admitted to hospital with a stroke are in atrial fibrillation. Approximately 12,500 strokes a year are directly attributed to atrial fibrillation and AF, as it is known, can increase the risk of stroke up to five times.
Appropriate treatment could prevent 4,500 strokes and 3,000 deaths each year and now a groundbreaking project in Bradford, led by the city’s clinicians, has led to fewer people suffering devastating strokes.
Well established evidence supporting the benefits of using anti-coagulation drugs led clinicians to focus on bringing those benefits to those earmarked in the city as being moderate to high risk of stroke.
The 18-month project, which concluded in April last year, was rolled out by more than 60 GP practices in Bradford City and Districts and Airedale, Wharfedale and Craven Clinical Commissioning Groups (CCGs).
Across the CCGs, there are 6,000 AF patients. Around 5,000 of them are deemed moderate to high risk of a stroke. However, only 2,300 were already being prescribed anticoagulation drugs as a precautionary measure Dr Matt Fay, GP specialist in cardiology who led the project, says AF is the most commonest form of a heart rhythm problem. “In the over-60s one in ten people are affected, and even if it doesn’t have any symptoms, your stroke risk is increased by a factor of five. You are five times more likely to have a stroke with AF,” he explains.
He says evidence has proved the introduction of anti-coagulation drugs reduces the risk of a stroke with AF by 70 per cent compared to the 18 per cent reduction with aspirin. “No medication is as powerful a preventative,” he adds.
“As far as I am aware, no-one else anywhere has undertaken a project such as this which has resulted in a dramatic positive effect on the health of patients. All strokes are devastating, but AF strokes are bigger and potentially lethal. Sadly 15 per cent of people who suffer an AF stroke die during the hospital admission and 50 per cent of sufferers will need long-term care.”
Greg Fell, consultant in public health who was involved in the project, says: “This is groundbreaking certainly for the UK and may be groundbreaking for the World.”
He says it is a ‘feather in the cap’ for Bradford GPs and the city.
“This project is way in advance of anything that has been achieved in this country or anywhere else, and this good work must continue.
“NICE (National Institute for Health and Care Excellence) has just released revised guidelines which support the use of anticoagulants for AF patients, which only goes to endorse the importance of this project and how Bradford GPs have had the vision to lead the way.”
Someone who has benefited from the treatment is Barbara Edwards, 65, from Eldwick, who suffered a stroke on New Year’s Eve 2012, but didn’t associate her feelings of being confused and problems with spatial awareness with having a stroke.
Barbara sought medical advice and discovered she had AF, a condition that is often hereditary. “It was a great surprise to me to find out that I had AF. It had not been picked up before. It has been important for me to know so that I can manage it with the right medication,” says Barbara.
“It was a very frightening experience and it was equally frightening to be told I had something I had not heard of.
“I’m sure a lot of people suffer from AF but are now aware of it,” says Barbara. “You can’t stop AF, but you can manage it, if you know about it.”
“I think it is really good that local doctors are also doing something about it and getting involved in it.”
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