Clinical Background
1.4 million people in the UK have atrial fibrillation; that’s 2.4% of the population. It’s known that in the 45 – 65 age group over 80% of people will suffer from the condition.
Public Health England (PHE) believes almost half a million people with AF remain undiagnosed. AF is known to be a direct cause of a third of all strokes and consequently 2,000 premature deaths per year. Early diagnosis could help avoid this.
AF and AF-related illness costs the National Health Service over £2.2 billion annually – a cost that is expected to rise as the incidence of AF increases due to the ageing population.
Current Clinical Pathway
The current clinical pathway varies according to each GP surgery and CCG but generally it can be a lengthy and costly process to achieve a definitive diagnosis.
The process typically begins with a manual pulse check and then auscultation, a 5 or 12 lead ECG in the surgery is followed by a 24 hour ECG tape or seven day Holter recording which then has to be analysed. With a positive (or indecisive) test, the patient is then referred to a cardiologist. If a diagnosis of AF is confirmed, the patient is then referred back to the GP for anticoagulant therapy.
PHE estimates that 2,000,000 people in the UK have Atrial Fibrillation and that the cost per patient using the current pathway is £1,305 without interventional procedures. This includes three GP visits, 12 lead ECG and Holter recordings, and outpatient costs.
The cost reduction achieved by using Kardia Mobile is significant. Assuming the patient requires two GP visits and a Kardia Mobile is provided for each patient, the cost is £189 rising to £352 if a patient is also sent for a 12 lead ECG. The minimum saving is therefore in the region of £950 per patient.
The cost to the NHS of screening the population with the current pathway is prohibitive. Kardia Mobile makes it possible.
Cost £ Of Current Pathway
| First GP visit (incl. ECG test) | £81 |
| Outpatients | £230 |
| 24 hr ECG | £163 |
| 7 day Holter test | £163 |
| Outpatients and decision | £230 |
| Implantable loop recorder (ILP) | £4021-£4556 |
| Second GP visit | £45 |
| Total | £1305 with ILR £5861 |
Cost £ When Using Kardia Mobile
| First GP visit (incl. ECG test) | £81 |
| GP Supplies Kardia Mobile | £99 |
| Second GP visit | £81 |
| Total | £189 |
Therefore using the AliveCor Kardia Mobile is a faster, simpler and more effective pathway.
Added Benefits. Early diagnosis of AF in 30 seconds
In surgery, the GP or the nurse can use the Kardia Mobile for a quick check when a patient presents with palpitations, fast heart rate or irregular rhythm.
The presence of AF can be immediately identified. Due to its simplicity, speed of use and low cost, Kardia Mobile can routinely be used to screen patients for AF and become part of the protocol for health checks in key age groups.
It can also be used to screen newly registered patients, in the well woman/well man NHS health checks and to form part of the routine in flu clinics.
As AF may be transient in nature, a test in the GP’s surgery may still not reveal the presence of the condition. A doctor can then issue a Kardia device to the patient for home use to make a recording when he or she experiences symptoms.
Kardia Mobile will also provide a simple ECG rhythm strip recording with heart rate when used during home visits.
The Cost/Benefit Analysis Of Using The Kardia Includes
- Reduction in the number of ECG tests, 24 hour tapes and 7 day Holter recordings.
- Reduction in the number of GP appointments and outpatient appointments.
- Savings to the NHS through early diagnosis of AF and prevention of stroke.