Heart Rhythm Week runs from 5th – 11th June and this year's focus is on "Identifying the Undiagnosed Person", with the aim of making 1 million people pulse aware. Together, we can work to secure early diagnosis and improve outcomes for the many millions of people across the globe affected by arrhythmias.
Francis White, VP Sales & Business Development, Alivecor Ltd writes below about the dangers of strokes from Atrial Fibrillation and the advancement in testing technologies that are helping to design new models of care.
Detect, Protect, Correct and Perfect – 4 easy steps to save a life!
What's your choice?
It's not hard to skim through the Internet to find surveys and people quoted saying they would prefer to die than live debilitated from a stroke. What is less often known is that in the UK, stroke is in the top 5 killers (NHS Choices).
Behind approximately half of strokes that devastate lives is a common heart rhythm abnormality called Atrial Fibrillation. In fact, "every 15 seconds someone suffers an AF-related stroke. AF is the most powerful single risk factor for suffering a deadly or debilitating stroke." (AF Association)
For those of us lucky enough to be over 40, 1 out of every 4 of us will have atrial fibrillation in our lifetime and if left undetected, we could become a stroke timebomb! This timebomb can strike without warning and sadly the first time many people find out they have AF is directly following a stroke.
All this doom and gloom!
There is hope on the horizon. AF is indeed common and becoming more common every decade that we live; however it is surprisingly easy to detect with a simple device called an ECG (electrocardiogram).
The first practical electrocardiogram was invented in Leiden, Netherlands in 1901 by Willem Einthoven – when I say "practical" it was the size of a small car and the patient had to sit with hands and feet in buckets of water!
Image courtesy of Wikipedia
Fortunately, another inventor came along in 2012 with a credit card sized device that connected to a smartphone. That inventor (with 47 US patents), Dr David Albert was steeped in the world of Cardiology and had been working with a leading ECG company as their Chief Medical Scientist.
This breakthrough, now known as Kardia Mobile from AliveCor, has changed not just the size and ease of use of the ECG but has redefined the cost structure of this key investigation. Not only that, but you no longer need to be an expert to make a recording of a rhythm strip that can be used for remote diagnosis of cardiac arrhythmias and many now have purchased their own unit to use in their everyday life.
Image courtesy of Alivecor Ltd
Where does Care City fit into this story?
NHS England recognised that the organisations that make up the service very often struggle to fully embrace even proven technological innovations. This is not due to lack of willingness or ability but is multi-factorial as outlined in the Accelerated Access Review. One of the initiatives to redress some of these complex issues is the national Test Bed programme of which Care City is a shining example.
Boroughs in North East London, like much of the rest of England, have high rates of undiagnosed atrial fibrillation, which is a marker of high risk of stroke. Prevalence modelling suggests across Barking and Dagenham, Havering, Redbridge and Waltham Forest, there may be over 9000 undiagnosed patients with AF. There has been a push within the local health economy to review strategies to increase AF diagnosis rates in primary care.
Care City Innovation test bed staff have been collaborating with the front line NHS providers in testing new models of opportunistic screening. This is in Primary Care, both in community pharmacy and in general practice, using the Kardia Mobile device. So far, over 550 people have been screened for AF through these sites, of which approximately 38 were identified to have possible AF and 66 a heart rhythm abnormality and were referred onto other services. We are continuing to expand these models in primary care across the patch and are now working to support local partners in the redesign of their models of care, to increase AF diagnosis rates and to ensure timely and effective anticoagulation to reduce risk of stroke.
The goal is to design new models of care that can easily be transposed to other locations as well as make a significant impact to the needs of the local population.
It is energising and encouraging being a part of such a forward thinking environment that is Care City. This is our chance to help reshape the healthcare provision is what is currently a somewhat underserved population and shine the light for other geographies to follow.
As the AF Association says, "Detect, Protect, Correct and Perfect" and thus reduce the mostly preventable tragedy of AF related stroke in our families and communities.