Word on Health

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Word on Irregular Heart Beats

Our grateful thanks to the Arrhythmia Alliance  for their contribution to our on-air report which you can hear again via the audio player below. 

Many people do not realise the importance of a simple, manual pulse check in detecting a potential irregular heart rhythm.  Making people aware of their pulse and how to manually check for an irregular rhythm is a simple step towards a formal diagnosis of an arrhythmia.

Heart rhythm disorders are Britain’s biggest killer.

  • Arrhythmias cause at least 75,000 sudden cardiac deaths each year in the UK; over 200 every day, more deaths than breast cancer, lung cancer and AIDS combined
  • 120,000 people experience unexplained loss of consciousness each year, commonly a sign of a heart rhythm disorder
  • Atrial fibrillation (AF) causes 12,000 debilitating and fatal strokes in the UK each year
  • In the UK, it is known that over 500,000 people currently have undiagnosed atrial fibrillation (AF), which leaves them with an annual 5% risk of having a debilitating AF-related stroke
  • At the age of 40, we all have a 1 in 4 life-time risk of developing AF which increases the risk of stroke 500%
  • The easiest way to detect an arrhythmia is to feel the pulse – uneven, too fast, too slow? Making people aware of their pulse and how to manually check for an irregular rhythm is a simple step towards a formal diagnosis of an arrhythmia.

To learn how to take your pulse see below - there's a free guide and app available from the Know Your Pulsewebsite, which you can access here.

As we heard, on-air, several thousand pharmacists across the UK have agreed to provide free pulse checks - if anything needs addressing they can advise next steps.    

NHS Choices tell us that you can check your pulse by counting how many times your heart beats in a minute. This is also known as your heart rate.

Your heart rate can vary, depending on what you're doing. For example, it will be slower if you're sleeping and faster if you're exercising.

Finding your pulse 

You can find your pulse in places where an artery passes close to your skin, such as your wrist or neck.

To find your pulse in your wrist:

  • hold out one of your hands, with your palm facing upwards and your elbow slightly bent  
  • put the first finger (index) and middle finger of your other hand on the inside of your wrist, at the base of your thumb 
  • press your skin lightly until you can feel your pulse – if you can't feel anything, you may need to press a little harder or move your fingers around 

To find your pulse in your neck, press the same two fingers on the side of your neck in the soft hollow area just beside your windpipe.

Checking your pulse

When you find your pulse, either:

  • count the number of beats you feel for one full minute
  • count the number for 30 seconds and multiply by two 

The figure you get is the number of times per minute your heart is beating. It's known as your resting heart rate, as long as you've been resting for at least five minutes before checking your pulse.

You can also check if your pulse is regular or irregular by feeling its rhythm for about 20-30 seconds. Occasional irregular heartbeats, such as missed beats, are very common. However, if your pulse is irregular for a continued length of time, it can be a sign of atrial fibrillation (see below - a heart condition that causes an irregular and often abnormally fast heart rate). This becomes more common as you get older and affects about 10% of people over 75. 

If you're concerned about your pulse, see your GP.

What's a normal heart rate?

Most adults have a resting heart rate of 60-100 beats per minute (bpm). 

The fitter you are, the lower your resting heart rate is likely to be. For example, athletes may have a resting heart rate of 40-60 bpm or lower. 

You should contact your GP if you think your heart rate is continuously above 120 bpm or below 40 bpm, although this could just be normal for you.

Exercise and your pulse

If you check your pulse while you're exercising or immediately afterwards, it may give an indication of your fitness level. A heart rate monitor is also useful for recording your heart rate when resting and during exercise.

Aerobic activities such as walking, running and swimming are good types of exercise, because they increase your heart and breathing rates. 

Atrial fibrillation is a heart condition that causes an irregular and often abnormally fast heart rate.

A normal heart rate should be regular and between 60 and 100 beats a minute when you're resting. You can measure your heart rate by feeling the pulse in your neck or wrist. 

In atrial fibrillation, the heart rate is irregular and can sometimes be very fast. In some cases, it can be considerably higher than 100 beats a minute.

This can cause problems including dizziness, shortness of breath and tiredness. You may be aware of noticeable heart palpitations, where your heart feels like it's pounding, fluttering or beating irregularly, often for a few seconds or, in some cases, a few minutes.    

Sometimes, atrial fibrillation doesn't cause any symptoms and a person with it is completely unaware that their heart rate isn't regular.

When to see your GP

You should make an appointment to see your GP if:

  • you notice a sudden change in your heartbeat 
  • your heart rate is consistently lower than 60 or above 100 – particularly if you're experiencing other symptoms of atrial fibrillation, such as dizziness and shortness of breath    

See your GP as soon as possible if you have chest pain. 

What causes atrial fibrillation?

When the heart beats normally, its muscular walls contract (tighten and squeeze) to force blood out and around the body. They then relax, so the heart can fill with blood again. This process is repeated every time the heart beats.

In atrial fibrillation, the heart's upper chambers (atria) contract randomly and sometimes so fast that the heart muscle can't relax properly between contractions. This reduces the heart's efficiency and performance.

Atrial fibrillation occurs when abnormal electrical impulses suddenly start firing in the atria. These impulses override the heart's natural pacemaker, which can no longer control the rhythm of the heart. This causes you to have a highly irregular pulse rate.

The cause isn't fully understood, but it tends to occur in certain groups of people (see below) and may be triggered by certain situations, such as drinking excessive amounts of alcohol or smoking.

Atrial fibrillation can be defined in various ways, depending on the degree to which it affects you. For example:

  • paroxysmal atrial fibrillation – episodes come and go, and usually stop within 48 hours without any treatment 
  • persistent atrial fibrillation – each episode lasts for longer than seven days (or less when it's treated) 
  • long-standing persistent atrial fibrillation – this means you have had continuous atrial fibrillation for a year or longer 
  • permanent atrial fibrillation – atrial fibrillation is present all the time  

Who's affected?

Atrial fibrillation is the most common heart rhythm disturbance, affecting around one million people in the UK.

Atrial fibrillation can affect adults of any age, but it becomes more common as you get older. It affects about 7 in 100 people aged over 65, and more men than women have it. 

Atrial fibrillation is more likely to occur in people with other conditions, such as high blood pressure (hypertension), atherosclerosis, or a heart valve problem. 

Treating atrial fibrillation

Atrial fibrillation isn't usually life-threatening, but it can be uncomfortable and often requires treatment.

Treatment may involve: 

  • medication to prevent a stroke (people with atrial fibrillation are more at risk of having a stroke) 
  • medication to control the heart rate or rhythm 
  • cardioversion – where the heart is given a controlled electric shock to restore normal rhythm 
  • catheter ablation – where the area inside the heart that's causing the abnormal heart rhythm is destroyed using radiofrequency energy; you may then need to have a pacemaker fitted to help your heart beat regularly 

Atrial flutter

Atrial flutter is less common than atrial fibrillation, but shares the same symptoms, causes and possible complications. Around a third of people with atrial flutter also have atrial fibrillation.

Atrial flutter is similar to atrial fibrillation, but the rhythm in the atria is more organised and less chaotic than the abnormal patterns caused by atrial fibrillation.

Treatment for atrial flutter is also slightly different, because catheter ablation (see above) is considered to be the best treatment, whereas medication is often the first treatment used for atrial fibrillation.

Listen to this weeks radio report

All material on this website is provided for your information only and may not be construed as medical advice or instruction. No action or inaction should be taken based solely on the contents of this information; instead, readers should consult appropriate health professionals on any matter relating to their health and well-being.