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MORE THAN 40,000 people over the age of 50 have atrial fibrillation (AF), Ireland’s most common sustained form of an irregular heartbeat.

Dr Angie Brown, consultant cardiologist and Irish Heart’s medical director, explains to TheJournal.ie that people with AF have a “completely irregular” pulse, stating: ”We call it an irregularly irregular pulse.”

People with AF are five times more likely to have a stroke. They also have an increased risk of getting dementia and having heart failure.

Some 8,000 people in Ireland have a stroke every year, with AF playing a role in about one-third of these cases. The risk of developing AF increases with age and about one in four people over the age of 50 are likely to experience it.

Many people with the condition aren’t aware they have it as there are no symptoms in around 70% of cases, Brown tells us. For people who do experience symptoms, the most common are heart palpitations, dizziness, breathlessness and chest pains.

Brown explains that some people occasionally might have blackouts, but “that’s pretty rare”.

Fainting episodes

Les Carroll is one of the many people with AF who didn’t experience any symptoms before he was diagnosed about seven years ago.

The 62-year-old found out he had AF by chance.

“I’m not one for pushing the snooze button in the morning, I’d be straight up out of bed and into the bathroom. The next thing I know I’d wake up on the floor. I was only out for a couple of seconds but I’d be in a cold sweat.”

Les recalls to TheJournal.ie how he’d feel fine a few minutes later and go to work as normal.

This would initially happen about once a year but, when the fainting spells became more regular, Les went to the doctor.

“I had all sorts of tests to try to establish what was causing that … Nothing obvious showed up,” he says.

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When monitoring Les’s heart, doctors discovered the irregular heartbeat. He had developed AF but this was not causing the fainting episodes.

“It was a completely separate issue,” Les says, noting how postural hypotension – a form of low blood pressure that can happen when a person stands up from sitting or lying down – was the cause.

I was jumping up out of bed too quickly and the blood was not getting to my brain quickly enough.

Les says the fainting turned out to be a blessing in disguise as it led to him finding out he had AF and enabling him to reduce his risk of stroke.

Both the postural hypotension and AF are now under control, with Les taking medication to address the latter.

Les, who retired from the civil service in May, says he has always been fairly active and has a healthy diet so didn’t need to make many lifestyle changes.

He now coordinates a weekly stroke support group in Tallaght in Dublin, which provides stroke survivors with exercise tips and a social outlet as well as arranging guest speakers.

Feel the pulse 

In order to help diagnose AF, Irish Heart is encouraging people to feel their pulse at least twice a day.

Dr Brown explains how to check your pulse: “Take two fingers of one hand – the first and second fingers. Turn your palm up to the ceiling. Place [the two fingers] just below the thumb on the wrist, on the outside.

Feel around in that area until you feel the pulse, this is easier in some people than others. You might need to practice or switch arms. Once you can feel the tapping, it should be nice and regular.

Brown says a regular resting pulse ranges from about 60 to 90 beats per minute. (This can be slower for athletes or people on certain medication.)

A pulse over 100 or 120 beats per minute is “not normal”, nor is an irregular pulse. In this instance, Brown advises someone to see their doctor.

If a person is diagnosed with AF, Brown says: “The take home message is it can be treated.” A patient may be put on tablets to slow down their heart if it’s racing, and/or blood thinners if they’re at risk of developing blood clots.

In some acute cases, Brown says electric shock treatment may also be used to try to get the heart rate back to a regular rhythm.

Brown says factors that increase the risk of developing AF include being overweight or obese, having high blood pressure or diabetes, excessive alcohol consumption and lack of exercise. She advises people to make positive lifestyle changes where possible to help them decrease their risk of getting the condition.

More information on the Feel the Pulse campaign, which is supported by Pfizer and Bristol-Myers Squibb, can be read here. 

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