The National Clinical Programme for Stroke is delighted to launch a new initiative: Stroke Prevention and Atrial Fibrillation in Ireland (SPAFI) to address the prevention, treatment and cure of Atrial Fibrillation in Ireland
Atrial Fibrillation (AF) is the most common cardiac arrhythmia affecting at least 3% of Irish adults over 60 and 6 % over. The worldwide prevalence has been rising and is currently approximately 600 in men and 375 in women per 100,000 population.
Atrial Fibrillation is associated with almost one in three strokes in Ireland and is associated with more disabling neurological deficits. It is an age-related condition and in addition to the manifest risk of stroke the evidence for its role in cardiac failure with preserved left ventricular dysfunction, fatigue, poor quality of life and dementia is growing.
Atrial Fibrillation (AF) represents one of our greatest risks for neurological disability through stroke and dementia as we age and is one of the greatest public health issues of our time. Stroke Prevention and Atrial Fibrillation Ireland (SPAFI) aims to harness interdisciplinary expertise to address the prevention, detection, treatment and cure of AF in Ireland and underpin it with good education and research,” Prof Collins said. Europe has an ageing demography and a challenging increased prevalence of cases of AF is on the immediate horizon. The Stroke Alliance for Europe in its report “Burden of Stroke in Europe” has signalled a possible 58% increase in the absolute numbers of stroke in Ireland over the next decade or so and much of this can be accounted for by increasing numbers of AF-related stroke as our population ages. Reducing the incidence of AF and ensuring effective stroke prevention in cases of AF remains a key goal for all cardiovascular and stroke programmes.
Prof Rónán CollinsConsultant Geriatrician & Stroke Physician, Tallaght University Hospital, Co-Chair of SPAFI.
However, AF also occurs at a younger age and there are strong associations with blood pressure, obesity, alcohol overuse, family history and extreme exercise regimens. Much of this AF may be preventable by early recognition of risk and intervention and much AF may be cured by addressing such risks before AF becomes permanent or by a specialised electro-physiological procedures. Traditionally the risk of stroke in such patients has been under appreciated and our pathways to specialised assessment have been either underdeveloped or under-resourced. This needs to be addressed.
Stroke Prevention and Atrial Fibrillation Ireland (S.P.A.F.I) is an interdisciplinary initiative established to try and comprehensively address the challenge of AF and to try and answer some of our ‘known unknowns’ and discover our ‘unknown unknowns’ about the condition,” Dr John Keaney, Consultant Cardiologist and Electrophysiologist Mater Misericordiae University Hospital and co-Chair of SPAFI. For all the recent advances we are still in a relative infancy in our understanding of the pathophysiology of AF, its association with risk of stroke and other illnesses. While much progress has been made in the last 10 years in particular with collaborative interdisciplinary working and research between cardiologists, stroke physicians, primary care providers and industry, nevertheless there are many unanswered questions and dilemmas in AF and more collaborative work is needed.
Dr John KeaneyConsultant Cardiologist and Electrophysiologist Mater Misericordiae University Hospital and co-Chair of SPAFI
A steering group of cardiologists, geriatricians and stroke physicians, GPs, public health doctors, pharmacists, health economists and nurses (Advanced Nurse Practitioners and research) with an interest in AF , to focus on relevant areas of expertise and underpin a national approach to AF with a clear and economically articulated strategy. The initiative has the support of the Irish College of General Practitioners, Irish Heart Foundation, Irish Pharmacists Union, Royal College of Physicians of Ireland- HSE national stroke, older persons and chronic disease management programmes, Irish Cardiac Society and Irish Physicians in Geriatric medicine, Stroke Clinical Trials Network Ireland and has received positive feedback from international colleagues as the potential model to be adopted elsewhere to tackle AF effectively .
Speakers at the launch included:
The challenge of atrial fibrillation in Ireland- Dr Niamh Hannon
What’s new or missing in the EHRA practical guide to NOAC use in AF’-Prof. Jan Steffel
Educating the AF patient – what have we learned?- Dr Lien Desteghe
Can we prevent or cure AF? - an ageing conundrum- Prof John Camm
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