Clinical update
Atrial fibrillation Essential facts
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Atrial fibrillation (AF) causes an abnormal, sometimes fast pulse, and is the most common heart rhythm disturbance. It occurs when electrical impulses controlling the heart’s natural rhythm lose co-ordination. People with AF have a four or five times higher risk of stroke because it increases the risk of a blood clot forming in the chambers of the heart. The condition is responsible for 22,500 strokes a year in the UK, according to the British Heart Foundation (BHF).
British Heart Foundation www.bhf.org.uk NICE guidance on the management of atrial fibrillation (currently under review) guidance.nice.org.uk/CG36 Atrial Fibrillation Association www.atrialfibrillation.org.uk
What’s new
SPL
More than one million people in the UK now live with AF, figures from the BHF reveal. Over the past five years the number of people affected has risen by 20 per cent.
Signs/symptoms Symptoms can include palpitation, tiredness, shortness of breath, dizziness or feeling faint. Severity of symptoms varies, with some people having only mild signs, and others none at all.
Causes/risk factors The BHF says the causes of AF include high blood pressure, heart valve disease, overactive thyroid gland and excess alcohol consumption. It is also associated with heart disease. Age is a significant factor, with about 10 per cent of people over 65 affected by the condition, according to the Arrhythmia Alliance’s Know Your Pulse campaign. However, in many patients no particular underlying cause can be discovered.
Expert comment Amy Thompson is senior cardiac nurse at the British Heart Foundation
18 march 5 :: vol 28 no 27 :: 2014
Sometimes AF can be resolved once an underlying condition has been dealt with.
How you can help your patient Be aware that AF can be present without symptoms and take every opportunity to check patients’ pulses. The pulse will usually feel irregular and beats may be variable in strength. The Arrhythmia Alliance is calling for pulse checks to be routine in the NHS to prevent debilitating strokes and save thousands of lives. Once diagnosed, patients can be given an anticoagulant, such as warfarin, to reduce the risk of stroke, and be considered for other treatment options.
‘It is important that people with AF are diagnosed so that they can receive the care they need and avoid some of the serious complications, which include stroke. Nurses, particularly those in primary care, should take a patient’s pulse when they see them, as this is a useful test for picking up cases of AF. ‘This is especially vital for practice nurses running clinics for people with heart problems, because heart disease
Know your Pulse campaign www.knowyourpulse.org Articles from Nursing Standard: An overview of atrial fibrillation Richards G (2012) rcnpublishing. com/doi/abs/10.7748/ ns2012.08.26.52.47. c9254 Atrial fibrillation and primary stroke prevention Bloe C (2011) rcnpublishing.com/ doi/abs/10.7748/ ns2011.10.26.6.49.c8755
can increase the risk of developing AF. Pulse checks are not always routinely carried out and people may not have symptoms so are completely unaware that there is a problem. ‘The Know Your Pulse campaign calls for heart rates to be checked at every NHS health check and at flu vaccination clinics. Unfortunately, people are often not diagnosed until they have been admitted to hospital following a stroke.’
NURSING STANDARD
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Atrial fibrillation Essential facts
Find out more
Atrial fibrillation (AF) causes an abnormal, sometimes fast pulse, and is the most common heart rhythm disturbance. It occurs when electrical impulses controlling the heart’s natural rhythm lose co-ordination. People with AF have a four or five times higher risk of stroke because it increases the risk of a blood clot forming in the chambers of the heart. The condition is responsible for 22,500 strokes a year in the UK, according to the British Heart Foundation (BHF).
British Heart Foundation www.bhf.org.uk NICE guidance on the management of atrial fibrillation (currently under review) guidance.nice.org.uk/CG36 Atrial Fibrillation Association www.atrialfibrillation.org.uk
What’s new
SPL
More than one million people in the UK now live with AF, figures from the BHF reveal. Over the past five years the number of people affected has risen by 20 per cent.
Signs/symptoms Symptoms can include palpitation, tiredness, shortness of breath, dizziness or feeling faint. Severity of symptoms varies, with some people having only mild signs, and others none at all.
Causes/risk factors The BHF says the causes of AF include high blood pressure, heart valve disease, overactive thyroid gland and excess alcohol consumption. It is also associated with heart disease. Age is a significant factor, with about 10 per cent of people over 65 affected by the condition, according to the Arrhythmia Alliance’s Know Your Pulse campaign. However, in many patients no particular underlying cause can be discovered.
Expert comment Amy Thompson is senior cardiac nurse at the British Heart Foundation
18 march 5 :: vol 28 no 27 :: 2014
Sometimes AF can be resolved once an underlying condition has been dealt with.
How you can help your patient Be aware that AF can be present without symptoms and take every opportunity to check patients’ pulses. The pulse will usually feel irregular and beats may be variable in strength. The Arrhythmia Alliance is calling for pulse checks to be routine in the NHS to prevent debilitating strokes and save thousands of lives. Once diagnosed, patients can be given an anticoagulant, such as warfarin, to reduce the risk of stroke, and be considered for other treatment options.
‘It is important that people with AF are diagnosed so that they can receive the care they need and avoid some of the serious complications, which include stroke. Nurses, particularly those in primary care, should take a patient’s pulse when they see them, as this is a useful test for picking up cases of AF. ‘This is especially vital for practice nurses running clinics for people with heart problems, because heart disease
Know your Pulse campaign www.knowyourpulse.org Articles from Nursing Standard: An overview of atrial fibrillation Richards G (2012) rcnpublishing. com/doi/abs/10.7748/ ns2012.08.26.52.47. c9254 Atrial fibrillation and primary stroke prevention Bloe C (2011) rcnpublishing.com/ doi/abs/10.7748/ ns2011.10.26.6.49.c8755
can increase the risk of developing AF. Pulse checks are not always routinely carried out and people may not have symptoms so are completely unaware that there is a problem. ‘The Know Your Pulse campaign calls for heart rates to be checked at every NHS health check and at flu vaccination clinics. Unfortunately, people are often not diagnosed until they have been admitted to hospital following a stroke.’
NURSING STANDARD
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 23, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
