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Atrial fibrillation (AF) is a condition where the heart beats irregularly or rapidly. While AF itself is not dangerous, it’s important to diagnose and treat it because it increases the risk of other conditions, such as heart failure and stroke.

In AF, blood circulates in the heart in an abnormal way, so there is a tendency for clots to develop. These clots can break off and travel to all areas of the body in the bloodstream. If a clot blocks the brain artery, this can cause a stroke.

Symptoms of AF include an irregular pulse, heart palpitations or a ‘fluttering’ heartbeat, dizziness, tiredness and weakness. However, people often have no symptoms at all or only experience symptoms some of the time.

The impact

AF is very common, with almost three percent of Australian adults currently living with the condition – more than half a million Australians.1, 2

The prevalence of AF in Australians aged 55 years or more is projected to double over the next 20 years, as a result of an ageing population amongst other factors, while between 2007 to 2016, deaths from AF increased by 82 per cent.1, 3

AF is estimated to cost the Australian economy over $1.25 billion per year, through medical costs, the costs of long-term care for those with a stroke-related disability, and lost productive output.4

The risk

AF can occur in both men and women, and can occur at any age, though it is more common in those over 75 years of age. The most common causes of AF are ageing, having long-term high blood pressure or coronary heart disease, although the cause is not always known.

Over the age of 40, you have a 1 in 4 lifetime risk of AF. As you get older, your risk of developing AF increases. About 7 per cent of people over 65 have AF, and this increases to 10 per cent over the age of 75.5 At this stage, screening for the condition becomes even more important due to the increased risk of an associated stroke.

The risk of stroke is present even when AF is only experienced some of the time. One in every three strokes is linked to AF, and AF-linked strokes are more severe than other strokes. The risk is also higher if you have high blood pressure or diabetes, have had a previous stroke, or if you have heart failure or other conditions that might predispose you to stroke.

Screening for AF

To screen for AF, your doctor may do some tests including feeling your pulse or taking an electrocardiogram. Once AF is diagnosed, medication can be prescribed to successfully manage the condition or help stop clots forming inside the heart.

While only your doctor can diagnose AF, you can keep an eye on your heart health by regularly checking your pulse.

Your pulse can indicate how well your heart is working, how fast it beats, and its rhythm and strength. Keeping a record will help you notice if there is anything different or unusual with your results.

A normal pulse, or resting heart rate, ranges from 60 to 100 beats per minute. Your pulse should beat steadily and regularly. A pause or extra beat now and then is normal, but if you notice frequent skipped or extra beats, speak to your doctor. Also speak to your doctor if your pulse is consistently outside the normal range, as this may indicate an underlying problem.

What is HRI doing?

HRI is tackling the widespread problem of AF from a broad range of research angles. Our Heart Rhythm and Stroke Prevention Group is currently investigating further strategies to screen for AF, amongst other related projects.

References

  1. Ball J et al; Estimating the current and future prevalence of atrial fibrillation in the Australian adult population. Med J Aust 2015;202:32–5.
  2. Briffa T et al; Trends in incidence and prevalence of hospitalization for atrial fibrillation and associated mortality in Western Australia, 1995–2010. International Journal of Cardiology, 2016. 208: p. 19–25.
  3. Australian Bureau of Statistics 2018; Causes of Death 2017, ABS cat. no. 3303.0, September.
  4. PricewaterhouseCoopers; The Economic Costs of Atrial Fibrillation in Australia. 2010.
  5. Atrial Fibrillation Association Australia. Atrial Fibrillation (AF) Patient Information. 2013.

Projects

Collaboration with researchers in Oklahoma (USA) to screen for atrial fibrillation in tribal Indian Clinics

Collaboration with researchers in Toyama (Japan) to investigate the incremental yield of annual screening

Collaboration with researchers in Shanghai to screen for atrial fibrillation

Collaboration with Hamburg and Gutenberg Heart studies (Germany) on screening for atrial fibrillation

Collaboration with researchers in Frankfurt Germany about epidemiology of atrial fibrillation

Collaboration with researchers in Royal Melbourne Hospital to detect atrial fibrillation post stroke in Australia, Hong Kong and China (SPOT-AF)

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