HASTENinGS - Arrhythmia Screening Clinics

Referral Criteria for HASTENinGS

Please consider referral of patients who meet ALL the following criteria:

-  Suspected Paroxysmal Atrial Fibrillation (either palpitation or an irregular pulse)

-  Aged 40 years and over

-  No previous diagnosis of atrial fibrillation/atrial tachyarrhythmia

-  12-lead ECG demonstrates Sinus Rhythm

-  No significant electrolyte imbalance or thyrotoxicosis

-  Able to use the telephone for a brief triage

HASTE Network In Guildford and Surrey (HASTENinGS)

Atrial Fibrillation is a very common heart condition which causes 15-20% of all Stroke.  Its incidence rises with age and is therefore set to increase over the next 20 years . In Surrey there are 195,101 people over 65 years of age and it is estimated of these at least 4000 have undiagnosed permanent atrial fibrillation. An unknown number have transient or paroxysmal atrial fibrillation.

The majority of these people are not taking anticoagulants that could protect them from having a stroke.

There are two types of atrial fibrillation: transient- where the abnormal rhythm lasts between minutes and days and permanent atrial fibrillation. The former group is especially high risk for developing stroke because clots form after only 24 hours of atrial fibrillation which can then detach when normal rhythm and atrial wall movement are restored.   In any individual patient, episodes of transient atrial fibrillation usually lengthen in duration over several years- so a patient with intermittent atrial fibrillation will often eventually move on to have permanent atrial fibrillation. 

Detection of AF in this high risk group of patients is challenging because many patients are not aware that they have atrial fibrillation or have transient symptoms that cannot easily be diagnosed by GPs. To make matters even more difficult, many healthy people have an erratic pulse caused by innocuous ectopic beats (which are a variant of normal and carry no risk), so any public or GP pulse checking campaign has the potential for creating many false alarms: screening large groups of people with specialized equipment  is the only effective way to detect and treat the problem accurately.

Transient atrial fibrillation lasting minutes to hours is hard to diagnose because the electrocardiogram is completely normal between attacks- and diagnosis is only secured by making numerous recordings of heart rhythm over time. In hospital practice this is only achieved by using ambulatory ECG recorders for a week, an implantable recorder (ILR) for 2 years or perhaps by training the patient to take daily rhythm recordings over several weeks.

Because very few general practices have the necessary equipment to diagnose intermittent atrial fibrillation traditional healthcare requires all suspected cases to be referred to a hospital. Yet only a small proportion of people with an irregular pulse turn out to have atrial fibrillation so a large pulse awareness and screening program would generate many thousands of extra referrals that could overload Hospital resources.

HASTE and Haste Academy have been set up to provide a solution. 

Arrhythmia Screening in Primary care to reduce Stroke

A team of specialist Nurses and Cardiologists have set up a new screening network in Guildford and Waverley which will offer arrhythmia screening to GPs. This network is called HASTE Network in Guildford and Surrey or HASTENinGS for short.

The service is jointly funded by HASTE and Haste Academy which are UK Charities.

The clinics will initially be based from four local General Practices (marked on the map below): Fairlands Medical Centre, Merrow Park Surgery, Shere Surgery and Haslemere Health Centre.

Locations see map

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More details

Our Research

The University of Surrey and clinicians based at the Royal Surrey County Hospital will be conducting research into whether this new method of health care delivery is effective as well as researching more efficient and cost-effective methods for screening larger populations for paroxysmal atrial fibrillation. This will involve testing a new diagnostic method using simple heart rhythm recorders suitable for screening larger numbers of people.

Should the outcome be positive, Haste Academy may opt to continue providing the service to local CCGs through its subsidiary HASTE MEDICAL Ltd. 

Related Stories

Roger Taylor, Anthea Turner and Peter Alliss Launch Stroke Prevention DVD
Research project HASTENinGS
How Atrial Fibrillation causes a stroke
Research: Can biomarkers be used to define risk?
ECG Guru

 




Written by

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Edward Leatham is a Consultant Cardiologist in Surrey and a Trustee of Haste and Haste Academy.

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