WHF Roadmap for Non-Valvular Atrial Fibrillation
WHF has developed this roadmap with experts and its members to help identify the roadblocks and solutions. Whilst AF is not represented by a specific 25by25 target, it is a significant problem, in that it is often undiagnosed, and as a result a huge contributor to CVD premature mortality.
Between 1990 and 2013, although the global prevalence rate of AF decreased slightly, the overall number of AF cases increased, according to the Global Burden of Disease Study (GBD) 2013. The morbidity burden associated with AF, as measured by disability-adjusted life years (DALYs), also increased. Estimates of prevalence of AF, and DALYs associated with AF, are likely to underestimate true burden due to the high prevalence of asymptomatic AF (8) AF is also associated with high costs incurred by individuals, health care systems and economies.
Whilst Atrial Fibrillation is not represented by a specific 25by25 target, it is a significant problem, in that it is often undiagnosed, and as a result a huge contributor to CVD premature mortality. WHF has used the roadmap framework to give countries an insight into how this issue can be tackled, with the emphasis being on local adaptation and implementation strategies.
Atrial Fibrillation (AF) is associated with increased risk of stroke and is found in one third of all ischemic strokes. It is under-diagnosed and for this reason poises a significant burden of risk and economic cost, which, could be managed and reduced if diagnosed more effectively. AF is the commonest clinically significant arrhythmia. Consequences of AF can include, increased mortality, increased risk and severity of stroke, increased risk of hospitalization, reduction in quality of life, reduction of exercise capacity and increased risk of heart failure.
Long distances to clinics result in low numbers of rural patients presenting to clinics for screeningView Comments 0
Train community health workers or pharmacists to screen for possible AF with pulse-checking in non-clinic settings.
Educate at risk populations (e.g. those 65+ years of age) to self-screen with pulse checks.
Implement novel telemedicine technologies (e.g. transmission of ECG results from rural areas to urban facilities)
Shortage of health care professionals with training in AF, including interpretation of ECG, initiation of and monitoring of anticoagulation therapy.View Comments 0
Reluctance of physicians and patients to initiate oral anticoagulation (OAC) therapyView Comments 0
OACs potentially unaffordable for patient households, resulting in non-adherence to treatment regimeView Comments 0
Implement internationally recognized policies for the reduction of essential medicine costs.