heart rhythm checks

Guidance issued after health checks at vaccination centres help to reduce stroke risk

Offering older people a simple heart rhythm check when they get their COVID-19 jab is helping to reduce health risks associated with stroke.

Initial pilot projects have demonstrated the benefit of giving people aged over 65 attending vaccination centres the option of an additional check to establish if they have atrial fibrillation (AF), an irregular heart rhythm that is a major cause of stroke.

Now the Oxford Academic Health Science Network (AHSN), in collaboration with the clinical leads for stroke at the Getting It Right First Time (GIRFT) programme, are sharing guidance on delivering checks in vaccination centres, to help systems that wish to follow suit.

Targeted AF detection in COVID-19 vaccination clinics is available on the Oxford AHSN website: click here to download.

Risk factors for stroke are usually picked up at routine GP appointments, but the pandemic has meant far fewer of these face-to-face consultations have taken place.

The early focus of the mass vaccination campaign was on over-65s – the age group most at risk of stroke and other forms of cardiovascular disease. Offering targeted heart rhythm checks at vaccination centres has helped to reach some of these people.

Modelling suggests that 37 new cases of AF will be detected and one stroke prevented for every 5,000 people offered a heart rhythm check at a vaccination clinic each year. If everyone aged 65 and over was offered an annual rhythm check more than 1,000 strokes could be prevented in England every year.

The guide by the Oxford AHSN and GIRFT is the latest in a series of practical resources produced by the two organisations, along with other partners, to share best practice around cardiovascular disease prevention to counter disruption caused by the pandemic. See here for details of previous guidance.

An irregular pulse is an indication of AF, which is a major cause of stroke. An estimated 250,000 people in England have undetected AF and most are at a significantly increased risk of stroke. Once AF has been diagnosed, people can be counselled on their stroke risk and how to reduce it, and oral anticoagulation therapy started if appropriate.

Strokes cause life-changing disability and death. Reducing the risk of stroke improves quality of life and eases pressure on NHS and social care services.

One of the first locations to trial offering heart rhythm checks to over-65s in vaccination clinics was Slough. Dr Nithya Nanda, a GP in Slough and the East Berkshire CVD and diabetes clinical lead, said: “Lockdown restrictions meant we were seeing fewer people in primary care. Vaccinating our over-65 population presented a perfect opportunity to detect, protect and prevent stroke in high-risk patients with undetected atrial fibrillation. We have received good feedback from both patients and healthcare professionals. Making every contact count makes a difference.”

This approach has now been rolled out across the wider Frimley Health and Care integrated care system, with people being offered additional tests as part of a full NHS health check. These include blood pressure and diabetes screening.

27 May 2021