A quite astonishing rise in the number of people diagnosed with atrial fibrillation, (BHF, 2023)
John askes 10 questions
The video I have just recorded is based on this following article published by the British Heart Foundation (BHF). The title of the article is ‘Number of UK people with heart rhythm condition rises by 50% in a decade’. This is ‘according to our new figures’.
Just by way of background, the following electrocardiograph (ECG or EKG) represents a normal physiological sinus rhythm, the PQRST waves are in the correct order and are occurring regularly.
This following ECG was recorded from one of my young healthy students, showing the PQRST waves.
By contrast, when we look at the ECG rhythm from a patient in atrial fibrillation, (AF) we noticed that there are no organised P-waves because the contraction of the atria is erratic. There are the spikes representing the QRS complexes, which is the ventricular contraction, but we see these are occurring irregularly, this will therefore give rise to any irregular pulse.
This British Heart Foundation (BHF) article is of course interesting because of what it says and is all the more fascinating and tantalising for the information that it leaves out.
The article clearly states that 1.5 million people in the United Kingdom are currently suffering from atrial fibrillation. This is the most common abnormal rhythm of the heart where the top chambers of the heart are contracting erratically and rapidly, resulting in fibrillation with no active coordinated atrial muscular contraction.
The point of the BHF article is to highlight the 50% increase in AF diagnosis over the past decade. This means there are now 1.5 million recognised sufferers in the UK, up from 1 million in 2013. This is a big cause of morbidity effecting one in 45 people in the UK.
It the article’s estimate of, at least another 270,000 people with AF that remain undiagnosed is correct, this would give a total of 1,770,000 people affected in the UK.
The article also points out that a person with AF is five times more likely to suffer a stroke, with potentially fatal or life-changing consequences. AF if believed to be a contributary factor to one in five strokes.
In the video I demonstrate how to feel a radial pulse, fortunately, I could feel a regular pulse, unlike the irregular pulse characteristic of AF. Other symptoms of AF from the article include, palpitations, breathlessness and dizziness. Often AF may be paroxysmal, essentially meaning the abnormal rhythm can come and go.
Quoting directly from the article, from ‘Our medical director Professor Sir Nilesh Samani’.
‘These figures show a quite astonishing rise in the number of people diagnosed with atrial fibrillation.’
‘Research has helped us understand the links between atrial fibrillation and stroke ….’
‘We also need to continue to harness the power of science to develop new and innovative tools for identifying people at increased risk ….’
Ignoring the strange turn of phrase ‘the power of science’, the article goes on, ‘the figures have been released as we launch a new campaign calling on the public to support our research into heart and circulatory diseases.’ Earlier they had been described as ‘our new figures’.
From this I formulated some questions for consideration.
Where are these figures, are they in the public domain, or is the article only referring to the 50% increase figure?
If these figures are in the public domain, where are they? From which studies where they taken?
If these figures are not in the public domain, why are they not in the public domain?
What was the rate of increase or change in prevalence during 1919, 2020, 2021, 2022, 2023?
Has the increase been correlated with any particular factors that have changed between 2019 and 2023?
What is the strength of any possible correlations?
Is there temporality with possible correlations? (In other words, has a cause or causes been identified that came before the effect of more cases of AF diagnosed and suspected)
Is there a plausible pathophysiological mechanism to explain correlations?
How do UK figures of increased AF relate to other countries?
Are there any common factors that connect potential changes across differing countries?
I did find some figures from the Lancet, but these only gave data up to the end of 2017, only the first four years of ‘a decade’.
https://www.thelancet.com/journals/lanepe/article/PIIS2666-7762(22)00079-5/fulltext
Anyway, I ended the video with some advice from the NHS website relating to AF.
https://www.nhs.uk/conditions/atrial-fibrillation/
When to see a GP
See a GP 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 to make sure it's nothing serious.
Good to see you on substack, dr John. Quite impressive how you manage to sail around the youtube cliffs and mines. Avoiding the V word. Its very concerning and quite depressing that free speech is blocked. Happy to have substack!
John Campbell! Welcome to the Land of the Free (Speech) and the Home of (those) Brave enough to use it. I’d love to see you post your banned YouTube content here in some form. All the best, from Texas.