The aims of management of atrial fibrillation are to Detect, Protect, Correct and Perfect.

Detect: Diagnosing AF

The first and simplest way of determining if a patient might be in atrial fibrillation is by undertaking a pulse check. In community pharmacy this might be done, for example, when undertaking a blood pressure check (a pulse should always be checked before taking blood pressure using an automated BP machine as these machines are not accurate in patients with an irregular pulse), as part of a commissioned NHS Health Check programme or perhaps an AF screening programme.

If pharmacists are not familiar with or confident about checking a patient’s pulse, the British Heart Foundation has useful information and a video on How To Check Your Pulse.

With improvements in technology, some mobile devices are available that can record a ‘one-lead rhythm strip’ to support or refute a possible AF diagnosis. Although these are not routinely available across the NHS, they may be in use in some regions as part of an AF screening programme.

If the pulse is found to be irregular, this may mean the patient has AF even if they do not have any symptoms. The patient should be referred, depending on the local pathway, for a ‘12-lead ECG’ to confirm the diagnosis.