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Atrial fibrillation and why it matters

Atrial fibrillation is an irregular heart rhythm. Instead of the heart beating regularly like normal, the heart beat is irregular and may also be faster than normal. Sometimes the irregular heartbeat of atrial fibrillation will cause symptoms such as palpitations, light-headedness or shortness of breath. Other people may not have any symptoms at all. The irregular heart beat may also come and go, something more common when the atrial fibrillation has only recently started.

Unfortunately the irregular heart beat can cause problems even when it is not causing any symptoms or is only happening some of the time. The most serious is that small clots can form in the heart due to the irregular beating and these may then travel in the blood supply to the brain, where they can cause a stroke. People with atrial fibrillation are thought to be around five times more likely to have a stroke. Reassuringly treatment is available in the form of blood thinning medication which can significantly reduce the risk of having a stroke in those who are suitable to take it.

The AMALFI study; what is the purpose?

Diagnosing atrial fibrillation is normally done using an electrocardiogram (ECG) which catches the heart rate at a single point in time. However, as atrial fibrillation may only be happening some of the time this test might not always detect atrial fibrillation if by chance the heart is beating regularly when the ECG is done. Also people who do not have symptoms from their atrial fibrillation are unlikely to see their doctor to have their pulse checked and have an ECG done.

The purpose of the AMALFI study is to see whether wearing a new home monitor called a Zio Patch, which can give a continuous heart trace reading for 2 weeks, will increase the number of people we can detect with atrial fibrillation. The hope is that this would allow more people to be put on the right treatment at an earlier stage and so bring down their risk of having a stroke.

The study has been approved by an independent Research Ethics Committee, which includes medical professionals and members of the general public. The Ethics Committee has reviewed all the study documentation as well as checking that the question the study is hoping to answer is important enough to warrant the research being undertaken.

AMALFI is supported by the National Institute for Health Research Biomedical Research Centre, Oxford. Government funding is provided to the NIHR with the aim of supporting new research and making sure the results of research studies go towards improving the healthcare received on a day to day basis in the United Kingdom.