Atrial fibrillation

Atrial fibrillation is the most common heart rhythm irregularity and is a major cause of stroke, heart failure, and death. Those with atrial fibrillation may be aware of noticeable heart palpitations. Others may feel breathless or just tired. In yet other patients, atrial fibrillation does not cause any symptoms at all, putting many people at risk who are completely unaware that their heart beats irregularly.

Research at the University of Birmingham is transforming how we understand atrial fibrillation and care for patients with the condition. Our work aims to protect every heartbeat, thereby helping to fight heart failure, stroke and sudden death.

Birmingham Heroes: Professor Paulus Kirchhof talks about atrial fibrillation

Detecting atrial fibrillation earlier and preventing stroke

One major challenge with atrial fibrillation is that it can often go undetected until someone experiences a stroke. Our research has identified novel ideas to improve screening for patients with atrial fibrillation.

Once atrial fibrillation is diagnosed, a risk score with six easy questions is now used throughout the world to identify those patients who are at high risk of stroke (the CHA₂DS₂VASc score). This score now enables health care professionals to initiate anticoagulation (treatment with blood thinners) to prevent stroke in patients with atrial fibrillation.

Dr Winnie Chua

“Keeping our heart healthy protects our brain from stroke and dementia. We’re studying cardiac biomarkers in the blood to help doctors detect atrial fibrillation earlier and prevent cardiovascular-related cognitive decline.”

Understanding the causes of heart failure

Even with optimal stroke prevention, people with atrial fibrillation are still at risk of heart failure and sudden death.

We integrate genomic information with population risk factors and a thorough understanding of the physiology of the beating heart and of cardiomyocytes to identify the mechanisms of heart failure in patients with atrial fibrillation.

Through our work we have influenced treatment of these conditions, including intelligent concepts for rhythm control therapy and new options for patients with heart failure and atrial fibrillation. This research has informed current international guidelines for the management of patients with atrial fibrillation.

Innovative technological tools and apps now help nurses, doctors, and patients themselves to choose the right treatment for patients with atrial fibrillation. Thus, our work also supports patients to take ownership of their condition.

Professor Paulus Kirchhof

“We’re helping patients to take ownership of managing atrial fibrillation, and enabling both healthcare professionals and patients to make informed decisions based on the best available scientific evidence.”

Putting the patient at the heart of the care process

We are developing integrated, patient-centred approaches to atrial fibrillation care to provide access to all forms of treatment and to ensure continuous management for all patients with the condition, transferring concepts tested in other areas of medicine.

We are supporting, educating and empowering patients with atrial fibrillation and their families by developing the ‘My AF’ app, collaborating with the CATCH ME Consortium (Characterizing Atrial fibrillation by Translating its Causes into Health Modifiers in the Elderly) and the European Heart Rhythm Association (EHRA).

We are working to integrate the 'MyAF' app with the associated ‘AF Manager’ app, so that healthcare professionals can work with patients to manage atrial fibrillation together.

Professor Dipak Kotecha

“New technologies and novel approaches have a huge potential to improve the daily lives of patients with atrial fibrillation, heart failure and other cardiovascular conditions. We are collaborating across disciplines to bring artificial intelligence, wearable devices and new scientific discoveries into patient care, for better diagnosis and treatment.”

Apps to support people with atrial fibrillation

Patients - download the 'My AF' app

Healthcare professionals - download the 'AF Manager' app

Further information about the apps is available on the European Society of Cardiology website.

Ongoing research

We collaborate closely with regional, national, and international partners to further improve our understanding of atrial fibrillation which will enable precision medicine for patients. As patients are at the centre of our work, we involve them in designing our studies from early on in the planning phase.

Ongoing clinical trials and research projects include:

Rate-AF trial - The RAte control Therapy Evaluation in Atrial Fibrillation (RATE-AF) trial is an NIHR-funded randomised trial of rate-control in older patients with permanent atrial fibrillation, assessing the impact of therapy on quality of life and cardiac function.
IMPRESS-AF - A study that tests the value of the medication sprionolactone in patients with chronic atrial fibrillation.
EAST - AFNET 4 trial - A study that will provide a contemporary and definitive answer on the prognostic effect of early rhythm control therapy in patients with AF.
NOAH - AFNET 6 – A study that evaluates the effectiveness of oral anticoagulation in patients with very rare atrial arrhythmias detected by pacemakers and defibrillators.

Professor Larissa Fabritz

“Together with our international partners, we characterise patient groups with different types of atrial fibrillation. Knowing how atrial fibrillation develops will help selecting the right treatments at the right time for specific patients. Thereby we hope to improve treatment success, and to reduce complications.”