Hundreds of Australians could be spared from stroke each year if people with an irregular heart beat had their condition treated, an Australian-led review claims.
The Heart Research Institute is leading a global push to introduce screening for the common heart condition atrial fibrillation which triggers catastrophic strokes.
Writing in the prestigious medical journal The Lancet, cardiologist and heart authority Dr Ben Freedman makes a case for routine testing of all older Australians to ensure all those with the heart condition are treated.
“We’ve estimated that by screening 75 per cent of people aged over 65 and getting 80 per cent with atrial fibrillation (AF) on to medication, we’ll be preventing more than 250 strokes every year,” Dr Freedman says.
“Given AF is linked to the most severe, catastrophic strokes, this simple approach would spare families a lot of pain, frustration and heartache.”
The Lancet review has been released to coincide with the world’s largest cardiology meeting, ESC Congress, where global heart experts will formulate a consensus statement to push for AF screening. Dr Freedman is co-founder of the group, AF-SCREEN International Collaboration, which will urge governments worldwide to extend stroke prevention measures to save lives.
With more than 50,000 strokes in Australia each year – 1000 a week or one every ten minutes – the need for action is clear, the expert says 1
“We now know that one in every three of these strokes are linked to AF, a common condition affecting five per cent of older Australians, in which the heart beats irregularly or rapidly,” Dr Freedman says 2 “And in about a third of these AF-linked strokes, the heart condition wasn’t diagnosed until after the stroke occurred.”
Strokes from AF are larger, more severe and harder to survive than other strokes because they are caused by clots that form inside the heart and break off. “The clots end up in a brain artery causing a ‘brain attack’ or stroke, that might be preventable if we could detect AF and give drugs which prevent clots,” he explains.
Blood thinners successfully manage AF but many Australians opt not to take them. Dr Freedman thinks uptake of medication would be considerably higher if AF patients knew they were helping prevent stroke. “Armed with this information, it’s highly likely a lot of older people with the heart rhythm issue would manage it better,” he says.
A screening program would ensure those with silent AF get a diagnosis and manage their stroke risk even when their heart condition carries no symptoms.
While the AF-stroke link has been known in medical circles for some time, Dr Freedman says there’s growing impetus to do something about it. And with the help of novel high-tech tools like smartphone ECGs, a fast, low-cost diagnosis is now possible.
With work by AF-SCREEN International Collaboration, an Australian screening program could be in place by 2020.
Dr Freedman says people can take action in the meantime. “If you are aged 65 years or over, then you can see your doctor to check your pulse, or check your own at home to see if it’s regular like a clock,” he says. “If it’s irregular you can have an ECG and get the condition managed.
“It’s a decision that could save your life.”
The Lancet review, Stroke Prevention in Atrial Fibrillation, was written by Dr Freedman in partnership with Tatjana Potpara of University of Belgrade in Serbia and Gregory Lip of University of Birmingham Institute of Cardiovascular Science in United Kingdom.
To read about this research in The Sydney Morning Herald, click here.
1 Deloitte Access Economics – Stroke in Australia: No postcode untouched, 2014
2 Med J Aust 2015; 202 (1): 32-35. Estimating the current and future prevalence of atrial fibrillation in the Australian adult population, Simon Stewart