What is atrial fibrillation?
D2AF stands for Detecting and Diagnosing Atrial Fibrillation. Atrial fibrillation is an arrhythmia in which the heart beats rapidly and irregularly. Some people feel palpitations when this happens. Others become dizzy, tired or short of breath. Other people experience no complaints at all.
Atrial fibrillation occurs at all ages. However, the risk of acquiring atrial fibrillation increases with age. It occurs in one in twenty people aged 65 years and over, in one in ten people aged 75 and over and one in five in people aged 85 and over. People with a heart condition and hypertension also have a higher risk of atrial fibrillation.
The risk of stroke and heart failure is larger in people with atrial fibrillation. These are serious consequences of this arrhythmia. Treatment with medication reduces this risk, so serious consequences can often be prevented.
What is the objective of the D2AF study?
Atrial fibrillation doesn’t always cause symptoms. In addition, the arrhythmia can also occur intermittently. Because of this, detection of atrial fibrillation is complicated. The objective of the D2AF study is to detect atrial fibrillation in an early stage, i.e. before a serious event has occurred. The sooner it is diagnosed, the sooner treatment can be initiated, the more serious consequences can be averted. That is why it is important to find as many people with atrial fibrillation as possible.
How is the study performed?
General practitioners from the Netherlands are asked to participate. Participating practices are divided into two groups. In one group we test different methods of detecting atrial fibrillation; this is the intervention group. In the other group the general practitioner delivers care as usual; this is the control group. Afterwards we compare both groups and evaluate whether our intervention resulted in the detection of more patients with atrial fibrillation.
We perform the following tests in the intervention group:
- Pulse palpation
- Automatic blood pressure measurement with a device that also signals atrial fibrillation.
- Hand-ECG: this is a bar of approximately 30cm which makes a simple electrocardiogram (ECG) when grabbing both ends of the bar.
- Normal ECG
- Holter recorder: this device is taken home and records an ECG for two weeks.
After the study we will know what is the best way to detect atrial fibrillation in primary care. The D2AF study will thus be able to make a significant contribution to the prevention of serious consequences of atrial fibrillation.