Reducing arrhythmia is key to tackling UK stroke endemic


Heart rhythm problems affect millions in the UK. But what can be done to prevent them? In an article first published by Mediaplanet in The Guardian, Dr Jonathan Clague of RB&HH Specialist Care explains why people need to know about the damaging effect of alcohol on cardiovascular health

At some stage in everyone’s life, there’s been that moment where the heart has done something unexpected. The smallest jump or flutter can serve as a reminder that the heart is there, beating away and keeping us going. 

Regular or even semi-regular episodes of palpitations, fatigue or unusual shortness of breath, however, could hint at a more serious cardiac condition that may require intervention. Arrhythmia is where the heart’s rhythm has fallen out of sync; beating either too fast or too slow. Of these conditions, atrial fibrillation is by far the most common, affecting the top chambers of the heart known as the atria. 

The chaotic, inefficient beating of the heart that results from atrial fibrillation (AF) can contribute to further and more serious risks if left undiagnosed or untreated. AF is now a leading cause of strokes in the UK. This is because the heart might not empty itself of blood at each beat, and a clot can form in the blood left behind, which can travel in the bloodstream to the brain and block the blood flow.

More common in men
Dr Jonathan Clague, consultant cardiologist at Royal Brompton & Harefield Hospitals Specialist Care, believes that it’s important to prevent AF from developing in the first place. It is more common in men than in women, with alcohol consumption the single largest contributory factor in developing the condition.

“A typical person who develops paroxysmal atrial fibrillation [occurring every now and again] is a man in his 40s or 50s who exercises excessively and drinks a little too much,” says Dr Clague. “It’s a complete misconception that you can offset your alcohol consumption through pushing your body through extreme exercise. It’s exactly the wrong thing to do. The latest guidance on alcohol consumption for women and men is that it’s safest not to drink more than 14 units a week.”

If someone is concerned about their heart rhythm, there are novel and innovative ways to diagnose and treat it. If the problem is persistent, with the heart constantly out of rhythm, it’s easy to diagnose with an electrocardiogram (ECG). However, irregular symptoms may require testing with a holter monitor—a small ECG machine worn for several days—to find out if the cause is AF.

Specialist expertise
Once diagnosed, specialist expertise is needed to correct the heart’s rhythm. Dr Clague explains: “Increasingly, we’re using a technique called ablation to treat AF. Specially-trained cardiologists insert catheters into the body and destroy small areas inside the upper part of the heart, to stop the abnormal impulses occurring.”

It is a challenging procedure, which carries some risks of its own, but amazingly it can be completed without open heart surgery. Instead, the heart is reached through thin, flexible tubes called catheters, which are typically placed into a vein that leads from the groin to the heart.

Increased awareness of arrhythmia is a priority, but its common causes must also be understood and taken seriously. Dr Clague believes this is vital to tackling AF and reducing stroke cases in the UK. “There can be no excuse for a smoker to say, ‘I didn’t know that smoking was harmful’. People know that alcohol can cause liver damage and mental problems, but they don’t know that it also can cause heart problems.”


Key stats

— One in four people will develop atrial fibrillation (AF) (source: Atrial Fibrillation Association) 
— There are over 1 million people with atrial fibrillation in the UK (source: Stroke Association) 
— Atrial fibrillation increases your risk of stroke by five times (source: Stroke Association)
— Every 15 seconds someone suffers an AF-related stroke. AF is the most powerful single risk factor for suffering a deadly or debilitating stroke (source: Atrial Fibrillation Association ) 
— There are more than 100,000 strokes in the UK each year. That is around one stroke every five minutes (source: Stroke Association) 
— Around one in six men will have a stroke in their life (source: Stroke Association)
— Around one in fice women will have a stroke in their life (source: Stroke Association)
— The effects of stroke can include communication problems, tiredness and fatigue, emotional changes and pain (source: Stroke Association)