Atrial Fibrillation detection

As part of a national Academic Health Science Network (AHSN) project to increase detection of AF, the HIN welcomed expressions of interest from local CCGs and networks to trial mobile ECG devices for opportunistic testing for AF within their practice. 400 mobile ECG devices were distributed in a variety of settings in south London, helping to identify more people with AF who can then be treated to reduce the risk of stroke. 597 cases of possible AF were identified preventing a possible 23 strokes, saving a potential 5 lives and avoiding potential health costs of nearly £310K.

Read the project report here

Through the device distribution work, ‘high impact’ settings were identified to further reduce the south London AF detection gap.

1. Flu vaccination clinics – With a high volume of people over 65, at higher risk of AF, flu vaccination clinics are a perfect setting to opportunistically test for AF. Wandsworth CCG conducted pulse checks across 23 practices through a flu clinics season finding 27 new cases of AF and 125 patients with existing AF were coded.
2. Community Podiatry – Similar to flu vaccination clinics, users of community podiatry services are likely to also have risk factors associated with increased risk of AF. The College of Podiatry produced a report in 2018 on podiatric detection of Atrial Fibrillation – read it here
3. Mental Health – Risk factors for stroke are greater in those with a serious mental illness. Mobile ECG devices were provided to Oxleas NHS Foundation Trust where opportunistic testing was conducted alongside existing physical health checks.

We’d encourage all health settings to consider how you might be able to incorporate a 30 second pulse rhythm check into your service, either with a manual pulse palpation or mobile ECG device.

Useful Resources

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  BP@Home Evaluation Download
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  Improving AF detection in high-impact settings Download
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  National AF Programme and Toolkit Download