Astonishing rise in atrial fibrillation says BHF

what a warm welcome to today's talk Wednesday the 24th of May today now the director of the British Heart Foundation over the last few days has said that there's been an astonishing rise in the incidence of the diagnosis of atrial fibrillation this irregular heartbeat where the top chambers of the heartbeat completely irregularly they just fibrillate and the bottom chambers of the heart the ventricles as a result contract very irregularly giving rise to an irregular pulse which is often fast now before we look at what he's been saying and we'll be asking some pretty uh probing questions on this let's just look at the normal Rhythm and the abnormal Rhythm that we see on the ECG and let's uh look at the um how I can diagnose this on myself by palpating my pulse let's do that first so first of all here we're looking at a normal Rhythm this is called a sinus rhythm it's originating from the sinoatrial node in the heart and we see the normal wave we would expect the P this QRS and the T and it's fairly regular it's a normal sinus rhythm and we can see it refreshing there and currently the heart rate is 71. so that's what it should look like let's now compare that to atrial fibrillation for comparison now hereby contrast we see that this patient is in atrial fibrillation so the ventricles are still Contracting these spikes we can see here but the bit in between the atrial contraction is all completely irregular the atrio are fibrillating and this gives rise to a regular very irregular feel to the pulse so that is atrial fibrillation there and that's what has been an astonishing rise in in the United Kingdom I'm just going to check if I'm in atrial fibrillation myself at the moment so there's my left hand and if you move up to the wrist there in line with the thumb you've got that uh knobbly bit on the bone there the radius in line with the thumb then you've got that tendon there that pulls up when you move your hand you can feel it tightening and what's good to do is if you form a few fingers in a row like that and just put them flat on something then that gives you a bit more sensitivity and if you put your fingers on that tendon there and then just move them down over the radius there and press in that little Valley that little Notch you can feel there and if you press on that you can feel how regular your heart rate is that's the pulse good place to feel the pulse there and it should feel fairly regular in terms of rate and amplitude if it's irregular then that is uh an abnormal finding so what we're looking at today Lively comes from this article here a number of people with hard Rhythm condition Rise by 50 in a decade that's the article there and there's some fairly probing questions we want to ask about that but let's run through some of the main points of the article first of all so that's the title there and that's the reference there always check it out for yourself to make sure I'm not making this up now atrial fibria fibrillation 1.5 million sufferers in the UK it was 1 million in 2013 that's a 50 rise over a decade now of course immediately you're going to ask well when did this rise occur and the article doesn't tell us that'll be part of the question that we're going to be looking at in fact where they get these numbers from is a little mysterious but uh more on that in a minute um so they're saying it's a 50 rise in a decade one in 45 people in the UK currently have atrial fibrillation which is a very high number these people are times more likely to have a stroke potentially fatal or life-changing stroke now what happens here is because the top chambers of the heart aren't Contracting properly they're just fibrillating then that means there's pockets of blood that aren't being ejected with the contractions and you get sort of stagnant blood in the Atria and that can contract um because the edge aren't Contracting that can congeal rather and you get blood clots forming because of the stasis in the blood because it's just fluttering rather than purposefully Contracting so that makes perfect sense and of course we've known about this for as well as long as I've learned about these things for decades so more likely to have strokes um believed to contribute to one in five Strokes an estimated 270 000 people in the UK are undiagnosed they don't know they have it so that means there's possibly 1.77 million people in the United Kingdom who have atrial fibrillator fibrillation this is a remarkably High number when did these numbers go up more on that in a second because we're not actually told so I'll be asking those questions symptoms of atrial fibrillation palpations so so that's basically an awareness of the heart but you can feel that your heart is beating inside your chest or thumping inside your chest often you well it will be irregularly breathlessness dizziness and paroxysmal means that this can come and go so people can have this sum of the time and not have it at other times and typically it's fairly fast most atrial fibrillation is is fast atrial fibrillation although you can get slow versions as well typically the heart rate is well over a hundred actually but very irregular when you palpate the pulse a medical director uh Professor near lashes samini so this is the medical director of the British Heart Foundation these figures show a quite astonishing rise his words in the number of people diagnosed with atrial fibrillation they say researchers helped us understand the links between atrial fibrillation and stroke well yeah I guess it has but there was research that was probably done before the start of my career so it's slightly disingenuous there I can't remember a time when I didn't know um well I suppose when I was a first year student or something but at any time I've done Cardiology we've always known that atrial fibrillation increases the risk for stroke for cerebrovascular accident as blood clots can be leave the heart and go up to the cerebral vasculature we also need to continue to harness the power of science I'm sure I like it turn the phrase here but never mind harness the power of science to develop you in the Innovative tools for identifying people at increased risk well if that means we need to do some epidemiology on that I guess is is right the British Art Foundation also say um the figures have been released as we launch a new campaign rolling out calling on the public to support our research so basically they seems to be doing this to try and get money out of the public for their research um some of you might think this question marks over some aspects of the work with the British Art Foundation others of you might be quite happy with it but they're certainly looking for money here and actually in the second part of this article they do talk about an individual um who had a stroke and um talking about individuals if they give the permission is fine it's fine but it's just yeah if the gift of permission is fine which obviously this lady has the figures have been released as we launch our new campaign so they're trying to get public support they want your money for their research the campaign aims to inspire people's Wonder at the complexity and uh complexity of their own body um sure sure well sure yeah that's obviously true and how life-saving research can help if it goes wrong yes bodies are complex standard precious again that's fairly obvious anyway so we've got this great increased uh rate of atrial fibrillation but it doesn't say over which years it occurs so I've got some questions for the British Heart Foundation here that I'd like them to answer um what was the rage increase or change in prevalence during 2019 so pre-pandemic 2020 when there was a lot of covid and then 2021 2022 2023 when there was other interventions being carried out so basically we want a graph don't we but we're not given one so the British Art Foundation is saying they've got figures here data here but they're not telling us what it is which is rather frustrating really do they know what it is if they know what it is why isn't that being shared with the public do they have data that other agencies don't have if not why is that not being shared with the public or don't they have the data but this article certainly implies that they have the data because they're talking about this increase um has the entries been correlated with any particular factors that have been changed between 2019 and uh 20 23. so anything that's happened in that period of time that could have increased the rate of atrial fibrillation have any correlations been made they don't tell us that but I'm asking them that and if so what is the strength of these correlations is there a strong correlation if there's a strong correlation it's more likely to be causal is there a temporal correlation effect so temporal correlations means that the effect has to come after the course so is there a cause that's occurred and then there's been an effect after that cause I'd like to know that as well again we're not told that is there any temporal correlations we're not told um is of a plausible mechanism to explain correlations it's always better if correlations can be accompanied with some sort of plausible mechanism something that can explain what's going on in biological physiological terms for example is there anything that's affected The myocardium of the Atria that could have caused the abnormal rhythms a plausible mechanism of action unfortunately that one gets another question mark we're not told that how do UK figures have increased atrial fibrillation relate to other countries is this a global phenomena are there particular countries that have been through particular experiences where this this is higher we don't know we're not told but that would be an interesting question to ask might be a good line of scientific research for the British Art Foundation are there any common factors that connect potential changes across different countries as we've said now the reason it looks like the British Art Foundation are up to date with these numbers is I had a really good look around for where they could have got this data from and um yeah the only thing I can think is it's their own data because I can't find any of the data in the public domain all I could find that the most recent one was this article in the in the landsat regional health uh Europe uh the data that this was published in June 2022 so fairly up to date but the data only went up to 2017. and yet this article from the British Art Foundation was released in 2023 so presumably they've got data for 2017 18 19 20 21 22 and potentially for for 23. if so we would like that release please because this article is talking about um the increase up to the the present time um so quite where that um data is is actually a bit of a bit of a mystery now it would be remiss of me to finish this video without giving you some advice from the NHS website which I'll put a link for see a general practitioner or call 111 if you have chest pain that comes and goes you have chest pain that goes away quickly but you're still worried you notice a sudden change in your heartbeat your heart rate is consistently lower than 60 or above 100 particularly if you're experiencing other symptoms of atrial fibrillation such as dizziness and shortness of breath it's important to get medical advice and make sure it's nothing serious so I'll put that link there so um so I've got that's that's um says one two three four five six six or seven questions there for the British Art Foundation um that would really cast a lot of light on this but particularly what data do they have for 2019 2020 2021 2022 and 2023 and uh if they have that data why is it not in the public domain so we'll leave it there for now it is of a concern that there is more atrial fibrillation 1.77 million people in the UK with it which is uh it's a lot of people it's one in 45 people in the United Kingdom or more or higher than that I've got atrial fibrillation so a significant uh pathology and uh greatly increasing the risks of Strokes as well as being a problem in its own in his own right so we'll leave it there and hopefully we'll get some more data from the British Art Foundation soon we would hope thank you for watching

Channel: Dr. John Campbell

Views: 599,331

Keywords: physiology, nursing, NCLEX, health, disease, biology, medicine, nurse education, medical education, pathophysiology, campbell, human biology, human body

Id: Zoso8Um9P2M

Length: 14min 0sec (840 seconds)

Published: Wed May 24 2023

Reddit Comments

[u/WeAreBeingInvaded]

O céu é azul.