FIND-AF (Future Innovation in Novel Detection of Atrial Fibrillation)

By Dr Ramesh Nadarajah

Atrial fibrillation (AF) is the most common abnormal heart rhythm, and more cases are diagnosed each year in the NHS than the four most common causes of cancer combined.  It causes strokes because clots formed inside the heart break off and go to the brain. Thinning the blood with tablets called oral anticoagulants reduces the chance of stroke. However it is estimated over 300 000 people are living with undiagnosed AF, which leads to over 15,000 strokes per year in the NHS.

The NHS urgently needs a way to identify people likely to have undiagnosed AF so they can be diagnosed and treated appropriately. To address this major public health issue the British Heart Foundation have funded Dr Ramesh Nadarajah, Dr Jianhua Wu and Professor Chris P Gale, in LIDA, to develop a tool to support doctors using data that is routinely collected in primary care. To conduct this ground-breaking research they have taken advantage of the secure data storage and access, as well as technological infrastructure, within LIDA.

They have developed FIND-AF (Future Innovations in Novel Detection of Atrial Fibrillation), an artificial intelligence innovation that uses information in electronic health records to identify people who are at high risk of undiagnosed AF. This includes information such as a person’s age, their sex, and whether they have particular health conditions, for example high blood pressure or diabetes. FIND-AF was developed and tested in records of over 2 million people, using the technological infrastructure at LIDA, and has been found to be highly accurate. It has been developed to be implemented through the usual electronic health records systems used in the NHS, to ensure security of patient data, and to ensure the technology can benefit as many people as possible. In the UK, 98% of the population are registered with a GP so this tool has the possibility to provide vital health information to inform care across the full breadth of the population. Once risk is identified any one of a number of simple non-invasive tests can be used to diagnose AF, and healthcare professionals can then follow-through with stroke-preventing medication.

Now the British Heart Foundation and National Institute of Health Research have funded the team to take the next steps to bring this novel technology to the benefit of patients. FIND-AF will be tested in primary care to determine if its use increases the detection rates of AF in the community. In this study FIND-AF will be implemented in primary care practices across Yorkshire, reaching out across our socioeconomic and ethnically diverse population. The team are working with both clinical and research teams at primary care sites and Leeds Teaching Hospitals. If this study is successful the team will aim to conduct a larger study nationally and internationally. Importantly, are already proceeding with achieving the regulatory approvals to make FIND-AF available for use in the NHS to tackle this urgent major public health issue.