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Ventricular fibrillation (VF) is characterized by rapid (>300 beats a per minute), irregular electrical activation with variable electrocardiographic waveforms that prevents coordinated myocardial contraction, resulting in immediate loss of cardiac output.1 It most commonly occurs in the context of coronary artery disease.2,3 Resuscitation efforts are critically time-dependent: with each minute of untreated VF, the survival rate declines […]

153/AF detection – A successful GP practice-based care – Our experience in a rural Cornwall

A Dhulkotia (Presenting Author) - Launceston Medical Centre, NHS Kernow, Launceston, UK
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Published Online: Oct 3rd 2008 European Journal of Arrhythmia & Electrophysiology. 2019;5(Suppl. 1):abstr153
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Introduction: NHS long-term plan has AF as one of its three priority areas – and is calling for 89% of people with AF to be diagnosed within this time-frame. There are currently half a million people unaware that they have AF and are, therefore, at risk of suffering a debilitating or life-threatening, AF-related stroke. The only way this ambitious target will be met, and significant lives saved, is through a GP practice-based programme. The use of AliveCor Kardia in usual GP setting seems a great strategy. We are not aware of any similar program in primary care in UK.

Method: We utilised AliveCor Kardia by opportunistic screening for people attending GP premises. This system is led by healthcare assistants during NHS health check-ups and phlebotomy sessions. The practice nurses while performing routine chronic illness check-up including diabetic reviews, wound care, COPD clinics. All of this is done during their normal clinic times. A protocol was created to streamline the process which is recorded on our GP record system.

Results: Over 300 people have been offered such screening for atrial fibrillation since October 2018. Three people have had a positive diagnosis confirmed with 12-lead ECG. These have been treated as per standard UK primary care guidance. The risk assessment also revealed 7 borderline detections and were followed up with further ECG which were negative.

Conclusion: AF detection based in GP practice settings allows us to utilise a cohort of population which is already attending primary care for a reason. No added appointments are necessary.

This practice has empowered the HCA and Nursing team by offering a NHS plus service i.e. more than routine care. Positive People feedback has allowed this to be an ongoing plan.

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