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GPs ‘not being informed’ about patients at risk of stroke

Patients with pacemakers are being left at a higher risk of stroke because pacing clinics are not informing GP practices when they develop atrial fibrillation, say UK researchers.

Their study found a quarter of patients at pacing clinics were not being considered for anticoagulation therapy after they developed atrial fibrillation, because GPs were not being informed.

The retrospective review of the records of 282 patients attending routine outpatient pacing clinics in Norwich found around a third – 95 patients – developed atrial fibrillation.

Of these, three quarters had persistent atrial fibrillation and a quarter had paroxysmal atrial fibrillation.

But the researchers – presenting their data at the British Cardiovascular Society’s annual conference in Manchester last month – said only half of those with atrial fibrillation were not on anticoagulation therapy and that a major factor was that GPs were not being told.

For a quarter of the patients, their GP and hospital specialist were not informed that the patient had developed atrial fibrillation, so were never considered for anticoagulation therapy.

Lead author, Dr Vassilis Vassiliou, a specialist registrar in cardiology at Papworth Hospital said: ‘A routine pacing clinic review offers an ideal opportunity for identification of atrial fibrillation.

‘Liaising with the GP however, is essential to optimise anticoagulation uptake in this population.’

Dr Matthew Fay, a GP in Shipley, West Yorkshire, national clinical lead for NHS Improvement and adviser to the Atrial Fibrillation Association said the research demonstrated ‘the disconnect’ between primary and secondary care.

He said: ‘I wonder if with a great deal of the pacemaker clinics in the country being clinician led and heavily protocol led, why a simple notification to the GP could not be built in to that protocol?’

‘It would seem a shame, that after we have tried so hard to improve the quality of someone’s life we then leave them vulnerable to a disabling stroke.’