AF affects around one million people across the UK, including 85,000 in Scotland. Currently, strokes can be prevented by the use of anticoagulant medications, such as Warfarin. However, AF is not systematically tested for in primary care in Scotland, mainly due to lack of access to ECGs in primary care settings.
The Digital Health and Care Industry in collaboration with NHS24, Scottish Centre for Telehealth and Telecare (SCTT), AliveCor Inc., NHS Lothian and the University of Edinburgh developed a project to determine the feasibility of screening for atrial fibrillation in primary care using a hand held ECG monitor already available in the market.
A total of 24 GP practices across Lothian, Fife, Tayside, Glasgow, Ayrshire and Grampian are included in the pilot. Patients with chronic diseases (e.g. heart failure, diabetes, and hypertension) will be screened as part of the annual health appointments. The number of participants are 2,200 so far and it is expected to reach more than 5,000.
The way it works is that each participant ECG recording are sent securely by email to a cardiologist who assess if the ECG is easy to read and if AF is present. Participants with a provisional diagnosis of AF based on the hand-held ECG recording will be referred for a 12 lead ECG to confirm the diagnosis.
This project is currently in second phase factory. Results of the academic analysis and health economic assessment on the long term consequences of undetected AF and high prevalence of strokes could help reduce the number of undetected cases of AF and also can indicate the viability of deploying the pilot at a much large scale, such as to all Scotland and beyond.