It is estimated that around 450 strokes and 150 deaths could be avoided every year across the East Midlands thanks to a programme to test more patients for Atrial Fibrillation (AF).
The initiative to identify and treat AF – a leading cause of strokes - is being led by the East Midlands Academic Health Science Network (EMAHSN), in partnership with the East Midlands Clinical Network and Clinical Commissioning Groups (CCGs).

It will focus on improving the diagnosis of patients with AF by equipping GP practices across the region with electronic AF detection devices. From this week, GP practices in eight East Midlands CCG areas will receive the AliveCor devices, with plans in place to extend the programme to a further eight CCGs by March 2018.

The AF devices are iOS and Android compatible and deliver an accurate reading in 30 seconds. Patients simply place their fingers on the device - linked to a smartphone or tablet - and within seconds it identifies if they are at risk of AF, allowing swift action to be taken to help avoid the risk of a life-threatening stroke.

AF is one of the most common forms of abnormal heart rhythm and a major cause of stroke – which is the third biggest cause of premature death in the UK. People with AF are five times more likely to suffer a stroke and AF contributes to around one in every five strokes.

Having AF increases the risk of developing a blood clot inside the heart which can travel through your bloodstream to your brain and cause a stroke. AF can be treated by drugs called anticoagulants, which thin the blood to reduce the chance of clots forming.

People are more likely to die if their stroke is caused by AF, and AF-related strokes also lead to longer hospital stays, increasing the costs of NHS treatment and care. Disability caused by stroke can also have life changing consequences for patients and their families and often means ongoing NHS treatment and social care support is needed.

Public Health England estimates there are 36,000 undiagnosed AF patients within the East Midlands. Currently people are tested for AF by a health professional checking their pulse by hand. Whilst this is effective, the new devices are more sensitive to pulse variations and allow patients to be tested quickly and easily at their local GP practice without the need for referral for an ECG (electrocardiogram) test.

The East Midlands Clinical Network has estimated that improving diagnosis and management of AF in the East Midlands could:

· Prevent an additional 448 strokes each year

· Prevent 149 deaths each year

· Avoid costs of £6.3m for hospital admissions and £4.5m for social care each year.

The East Midlands will be one of the first regions in the country to have full coverage of AF detection device roll-out when the programme is extended to cover all clinical commissioning groups in the region by March 2018.

Karen Glover, Head of Clinical Programmes at the East Midlands Academic Health Science Network, said: “AF is a major health concern for our region. Working with our partners to improve diagnosis will mean more life-saving treatment can be offered to patients as well as helping to reduce the cost of strokes to the NHS.”

Trudie Lobban MBE, Founder and Trustee, AF Association said: "This is excellent news for the many thousands of people with undiagnosed AF and therefore at risk of an AF-related stroke - the most debilitating and life-threatening of strokes. The use of hand-held detection technology together with a simple manual pulse rhythm check can help to identify people at risk of AF and we welcome the work of EMAHSN in disseminating this technology across GP practices."

Dr Neil Fraser, a GP in the Rushcliffe CCG area said: “Using AliveCor devices to instantly and accurately check heart rhythms really streamlines care for patients and raises awareness of AF. Coupled with our efforts to inspire GPs and nurses to opportunistically check pulses in routine clinical care, we can find hundreds of new AF cases, saving many lives and preventing permanent disability from strokes.”

Martin Cassidy, Network Senior Quality Improvement Manager, said: “This is a major programme that seeks to achieve a 10% increase in the number of patients diagnosed with Atrial Fibrillation over the next 12 months. With increased diagnosis we will be able to provide better care and raise awareness among health professionals and the public of this important and often undetected condition.”

Dr Yassir Javaid, a GP and Cardiovascular and Diabetes Clinical Lead at Nene CCG said: “I’m thrilled that we have been given this opportunity through the EMAHSN and East Midlands Clinical Network to improve outcomes for patients. By detecting more people with AF we can treat them more effectively and avoid many more preventable deaths in our region.”

The project will be formally evaluated by NIHR Collaboration for Leadership in Applied Health Research and Care (CLAHRC) East Midlands.

A video showing how the AliveCor Kardia mobile devices work is available here.

ENDS.

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Note to editors:

The East Midlands Academic Health Science Network (EMAHSN) is one of 15 Academic Health Science Networks in England. EMAHSN brings together the NHS, universities, industry and social care to transform the health of the region’s 4.6M residents and stimulate wealth. Current priorities focus on identifying and spreading innovations that address challenges including cancer, diabetes, mental health, atrial fibrillation and liver disease. www.healthinnovation-em.org.uk

East Midlands Clinical Networks enables patients, professionals and organisations to work together, across the East Midlands, on large and lasting programmes of quality improvement in four areas of major healthcare challenge. The network brings the right people and expertise together to help drive improvements (www.emsenate.nhs.uk).

Clinical Commissioning Groups to receive the devices:

· Corby CCG

· Lincolnshire East CCG

· Nottingham North & East CCG

· Nottingham West CCG

· Nottingham City CCG

· Rushcliffe CCG

· South Lincolnshire CCG

· Southern Derbyshire CCG

Supporting partners

· British Heart Foundation, Stroke Association and Arrhythmia Alliance

· Health Education England East Midlands

· NHS Right Care

· NIHR Collaboration for Leadership in Applied Health Research and Care East Midlands

· Public Health England East Midlands

· Pfizer

Background data

The East Midlands has higher rates of Atrial Fibrillation than the England average (1.79% compared to 1.71% - March 2016). AF rates range from 0.94% in the Leicester City CCG area to 2.46% in the Lincolnshire CCG area. There are a higher proportion of people aged 50 years and older in East Midlands compared with the national average and AF is more common the older you get.

Despite the improvements made within East Midlands to date, there are still a number of significant challenges to be met in stroke prevention in Atrial Fibrillation:

Across East Midlands 70% of the estimated AF population are diagnosed – however this ranges across CCGs from 56% to 77%.

The estimated total of AF is 120,428 (2.54%) compared to diagnosed population as of March 2016: 84,245 (1.79%)

An estimated 36,183 AF patients are undiagnosed (based on Public Health Estimates published February 2017).