Currently, up to 30% of individuals who have atrial fibrillation (AF) are undiagnosed and are at risk of complications, such as an AF-related stroke. So, it is important to know your pulse to know your heart rhythm.

What is atrial fibrillation?

Atrial fibrillation, or AF, is a heart condition that causes an irregular and often abnormally fast heart rhythm. It is the most common heart rhythm disturbance encountered by doctors, affecting around 1.4 million people in the UK. It can affect adults of any age but is more common as people get older; in the over-65-year-old age group, it affects about 10% of people.

AF causes irregular, rapid heartbeats

A normal heart rhythm should be regular and between 60 and 100 beats a minute when you are resting. In people with AF, it can be considerably higher than 100 beats a minute. This can cause problems including dizziness, shortness of breath and tiredness. You may be aware of noticeable heart palpitations, where your heart feels like it’s pounding, fluttering or beating irregularly — often for a few seconds or, in some cases, a few minutes.

AF is not a life-threatening heart rhythm problem, but it can be troublesome and often requires treatment. AF is more likely to occur in people with other conditions, such as high blood pressure (hypertension), atherosclerosis or a heart valve problem.

AF increases stroke risk significantly

People with atrial fibrillation have a five times greater risk of having a stroke. In some cases, atrial fibrillation can also lead to heart failure. So, it is very important to know the signs, detect AF, protect against AF-related stroke and correct the irregular heart rhythm. 

A normal heart rhythm should be regular and between 60 and 100 beats a minute when you are resting.

Know your pulse

Typical symptoms such as palpitations, chest pain, shortness of breath, fatigue, dizziness and fainting. However, this does not apply to everyone. Some people experience no symptoms at all and are considered ‘asymptomatic.’ Therefore, it is important to ‘Know Your Pulse to Know Your Heart Rhythm’ — it could save your life. Detecting an irregular pulse is often the only symptom of AF.

Reducing stroke risk and managing symptoms

It is important to reduce the risk of an AF-related stroke with anticoagulation therapy. Treatment for AF aims to restore the heart’s normal rhythm. If that’s not possible, the goal shifts to slowing the irregular heart rate to relieve symptoms.

Global AF Aware Week

The AF Association hosts Global AF Aware Week (GAFAW) each year. GAFAW on 18–24 November 2024 aims to raise awareness of AF across the globe so that people can be detected, protected and treated earlier and live healthier and happier lives.

Raising awareness of AF is vital for the public to understand the associated dangers, its link to stroke and the importance of a regular pulse rhythm check. Currently, up to 30% of individuals who have AF are undiagnosed and at risk of complications, such as AF-related stroke.

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Trudie Lobban MBE

Founder and Trustee, Arrhythmia Alliance

We can make a lasting impact on the health and wellbeing of people in low and middle-income countries (LMIC) by recycling pacemakers, which are currently put into landfills.

Recycling explanted cardiac devices to countries where they would not otherwise have the opportunity to receive treatment for heart rhythm disorders can provide valuable medical support.

Inequity of life-saving cardiac technology

In the UK, cardiac implantable devices give approximately 68,000 individuals a second chance at life each year. Yet, when a device user dies, the device is buried with them, or if the deceased chooses to be cremated, it is discarded and goes to landfill. 

Many times, a device has many years of battery life left and yet, it is a ‘throwaway.’ In stark contrast, in LMIC, around 2.5 million people die every year because they do not have enough money or access to a lifesaving cardiac device operation.

This is an opportunity that can protect our planet from harmful waste and provide life-saving cardiac care to others.

How cardiac devices can save a life, twice

Arrhythmia Alliance Pace4Life (A-A P4L) is a charity that tackles this disparity head-on by donating cardiac devices to people in need in LMIC who otherwise would not be able to afford the lifesaving implant. The charity sources cardiac devices, identifies viable clinics in LMIC, sets up programmes at these clinics, trains local cardiac teams, organises pacing missions and provides ongoing online support to those programmes. This is an opportunity that can protect our planet from harmful waste and provide life-saving cardiac care to others.

Repurposing cardiac devices for impact

The key is connecting LMIC and higher-income countries (HIC) communities through the reuse and recycling of pacemakers and other cardiac devices once they are no longer needed. By gathering these life-saving devices from hospitals, funeral homes, crematoriums and mortuaries, this programme can make a real difference in the lives of those in need. The aim is to ensure that every cardiac device is given a second chance to bring hope and healing to those who need it most.

A-A P4L has created a system that allows the repurposing of explanted and end-of-shelf-life cardiac devices and equipment. By redirecting these items to a distribution centre, the used devices are collected by a re-processing company, cleaned, decontaminated, tested and re-packaged sterile. The devices can positively impact the lives of those in need while contributing to a sustainable future by avoiding landfill.

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Find out how a cardiopulmonary resuscitation (CPR)-trained society will save more lives, improve public health and enhance community resilience during emergencies.

Our report, ‘Every Second Counts: Tackling inequalities in resuscitation’, reveals the huge disparities between rich and poor, and people from different cultural backgrounds, when facing the ultimate medical emergency.

CPR knowledge and access disparities

We spoke to people from African, Indian, Pakistani and Bangladeshi communities to understand their views and expectations about learning and performing CPR. Around 60% said they lacked the knowledge and skills to perform CPR, and 34% mentioned a lack of awareness of training opportunities.

Increasing CPR knowledge and training in underserved communities gives everyone an equal chance of surviving a cardiac arrest. Training resources must be tailored to people’s needs, where English may not be the primary language. Consideration must also be given to differences in technology literacy and digital access.

A lack of defibrillators

Defibs save lives, but our research suggests that they’re scarce in poorer parts of the UK. Almost half (44%) of these areas have no defibrillator registered on The Circuit, the national defibrillator network.

Increasing CPR knowledge and training in underserved communities gives everyone an equal chance of surviving a cardiac arrest.

We must change this by targeting public-access defibs in areas where the data tells us they’re needed most and ensure these devices are registered on The Circuit. This will be a significant step in reducing inequality and ensuring everyone has an equal chance of survival.

Closing the inequalities gap

We’ve made key recommendations for progress, and we’re asking decision-makers and our partners to work with us to adopt them. Collecting routine comprehensive data that effectivelyidentifies and targets out-of-hospital cardiac arrest hotspot areas will beinvaluable.

We also want CPR training to be part of the driver’s licence test and the DVSA’s Compulsory Basic Training (CBT) for motorcycles and mopeds. Around 180,000 moped and motorcycle drivers take the CBT test annually, which we believe could ensure greater CPR confidence in younger drivers, and many more from underserved communities.

Working together to save lives

Our success will require collaboration, commitment and ambition. We ask that Westminster and devolved governments work with us to fund a national public awareness campaign that targets CPR training in areas where it’s most needed. A CPR-trained society will save more lives, improve public health and enhance community resilience during emergencies.

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By harnessing artificial intelligence (AI), research is breaking new ground, finding new ways to diagnose, treat and care for those with heart conditions.

Medical technology is rapidly evolving, and AI innovations continue to drive advances in risk stratification and the better detection and treatment of cardiovascular disease.

Two new research studies funded by the British Heart Foundation (BHF) have embraced the power of NHS data to generate AI algorithms that have the potential to improve care for heart patients.

AI to accelerate clinical decisions

The first study — led by Dario Sesia, a BHF-supported PhD student at Imperial College London — developed a new AI tool that could help tens of thousands avoid unnecessary hospital stays each year in the UK. In the study of over 33,000 UK patients, their AI tool — Rapid-RO — successfully ruled out heart attacks in over a third of patients.

Rapidly ruling out heart attacks in those attending A&E could have a huge impact, allowing people to be reassured and safely sent home from hospital. Promising technology like this could help accelerate clinical decision-making and help people avoid unnecessary hospital admissions, as well as allow valuable NHS time and resources to be redirected to where it could have the greatest benefit.

Over 1 million people in the UK are affected by heart failure.

Identifying heart failure risk

Another study, led by Professor Chris Gale at the University of Leeds has used machine learning to spot people at risk of heart failure earlier.

The new tool — FIND-HF — identifies tell-tale patterns in individuals’ GP records to spot those at highest risk of developing heart failure. The team found that FIND-HF could accurately predict who was at highest risk of developing heart failure and who would consequently be hospitalised in the next five years. 

Over 1 million people in the UK are affected by heart failure. In the future, tools like this could be instrumental in helping spot some of the 200,000 new heart failure cases that are diagnosed every year in the UK. Earlier diagnosis could help many patients start treatments sooner — when heart failure symptoms can be managed more effectively and its progress can be slowed.

Advancing tools to mitigate heart diseases

Pioneering technologies funded by donations to the BHF have the potential to save and improve thousands of lives across the UK and globally. It’s only with funding that we can continue to drive forward new tools and treatments for heart and circulatory diseases, helping us achieve our mission to beat heartbreak forever.

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The link between what we eat and ‘heart health’ is well-established. Numerous studies highlight how certain foods can either reduce or increase the risk of cardiovascular disease.

Maintaining a healthy heart is vital for a long, fulfilling life. As a dietitian, I see firsthand how diet can influence cardiovascular health.

How much does diet really affect heart health?

Unhealthy eating habits are a leading cause of heart disease globally, including in the UK, where cardiovascular conditions contribute significantly to illness and death. A heart-healthy diet is not just about avoiding harmful foods; it’s about actively choosing nutrient-rich options that promote cardiovascular wellbeing.

This includes a diet rich in fruits, vegetables, whole grains, lean proteins and healthy fats. Minimise the intake of saturated fats, trans fats, sodium (salt) and added sugars — in short, avoid processed foods.

The recommended daily fibre
intake for adults is 30 grams.

Key components of a heart-healthy diet

Fruits and vegetables: These are loaded with vitamins, minerals, fibre, polyphenols and antioxidants. A study in the British Journal of Nutrition (2019) found that higher consumption of fruits and vegetables is linked to lower blood pressure and improved blood vessel function, both essential for heart health. Additionally, these foods help reduce inflammation and oxidative stress, which are key factors in the development of atherosclerosis.

Whole grains: Whole grains like oats, barley, beans, lentils and wholemeal bread are another essential part of a heart-healthy diet. They are high in dietary fibre, particularly soluble fibre, which helps lower ‘bad’ low-density lipoprotein (LDL) cholesterol and improves overall lipid profiles.

Increasing fibre intake is a powerful way to reduce cardiovascular disease risk. The recommended daily fibre intake for adults is 30 grams.

Healthy fats: The type of fat consumed is more important than the total amount when it comes to heart health. Unsaturated fats, often referred to as ‘healthy fats,’ are particularly beneficial. These fats — found in olive oil, nuts, seeds, avocados and oily fish — have protective effects against heart disease.

Research published in the Journal of the British Heart Foundation (2021) indicates that omega-3 fatty acids can lower the risk of heart attacks by reducing triglycerides, increasing ‘good’ high-density lipoprotein (HDL) cholesterol and stabilising heart rhythms.

Conversely, saturated and trans fats (common in processed foods) increase LDL cholesterol and the risk of heart disease. The Mediterranean diet, which is rich in healthy fats, has been associated with a lower incidence of cardiovascular disease.

Make conscious, heart-healthy choices

A heart-healthy diet isn’t about strict limitations but rather about making informed, balanced choices that support cardiovascular health. By focusing on the regular consumption of fruits, vegetables, whole grains and healthy fats, we can significantly reduce our risk of heart disease. As dietitians, our role is to guide individuals toward these healthier dietary choices, helping them protect their hearts and improve their overall quality of life.

[1] British Journal of Nutrition (2019). ‘Fruit and Vegetable Intake and Cardiovascular Health.’
[2] BMJ (2017). ‘Whole Grains and Coronary Heart Disease Risk: A Meta-Analysis.’
[3] Journal of the British Heart Foundation (2021). ‘Omega-3 Fatty Acids and Cardiovascular Risk Reduction.’
[4] European Heart Journal. (2019). ‘Fruit and Vegetable Intake and Risk of Cardiovascular Disease.’
[5] The Lancet. (2019). ‘Dietary Fiber Intake and Risk of Cardiovascular Disease.’
[6] Harvard T.H. Chan School of Public Health. (2021). ‘The Mediterranean Diet and Heart Health.’

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An echocardiogram provides a detailed heart assessment in just 30–60 minutes, helping diagnose and manage heart conditions effectively.

Having a heart imaging test that can give both clinicians and patients an overview of heart health is invaluable. It helps to confirm normality or identify, diagnose and aid in the management of heart disease. An ‘echocardiogram’ — or ‘echo’ — does just that.

Echocardiogram enables detailed assessments

An echo is a heart ultrasound scan that provides information on the heart’s size, structure, function and efficiency. In a nutshell, it provides a comprehensive assessment of your heart in as little as 30–60 minutes. It involves an ultrasound probe being placed on the left side of the chest, and images are transmitted to the echo machine screen.

Whether it’s the heart size, pump function, assessment of heart artery disease or an overview of the heart valves, an echo can look at it all. It is the most commonly requested heart imaging tool used worldwide in all ages.

An echo is the only heart imaging
modality undertaken across many
different medical disciplines.

Capabilities, versatility and portability

While looking at cardiac structure and function, an echo also helps to guide life-changing management; for example, in those with heart failure or to guide cancer therapy. It also gives the clinical team an idea of the heart’s capability, to help inform those wanting to return to more physical activity following the diagnosis of a cardiac condition.

Uniquely, an echo is the only heart imaging modality undertaken across many different medical disciplines within various settings, whether you are at the hospital or in the community. An echo is portable, allowing scans to be undertaken in A&E, intensive care, in a medical or surgical ward or at a GP practice.

Echo is provided across medical specialities by a variety of medical personnel. In fact, the vast majority of echos are performed by cardiac physiologists — one of the hidden workforces in our health system.

Increasing echocardiogram standards

Artificial intelligence (AI) will aid the detection and treatment of many medical conditions, and we are already seeing this help in the world of echo. We will still need highly trained specialists to carry out the echo, but the potential for AI to assist in the future is immense.

Your heart is your body’s engine, an echo is the MOT and much more. The British Society of Echocardiography ensures that the echo you receive — should you need it — is carried out by a highly qualified professional, with the appropriate skills. This is a role we take very seriously.

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