Irregularly Irregular pulse: To impact clinical practice with research

Abstract

Atrial fibrillation (AF) was first described in the oldest Chinese medical literature, Huangdi Neijing <黃帝內 經> in 2600 BC. It is the most common type of cardiac arrhythmia in clinical practice. Although AF is known to confer a five-time higher risk of stroke, which can be effectively reduced with anticoagulation therapy, the utilisation of anticoagulation therapy has been low amongst Chinese. In contrast to the robust body of evidence for Caucasian population with AF, the scarcity of data in Chinese AF patients makes the management challenging. The challenge includes delicate balancing the benefit of stroke risk reduction with the risk of intracranial haemorrhage as there are perceptions that Chinese might have a lower risk of stroke attributable to AF, and a higher baseline rate of intracranial haemorrhage. Over the last 7 years, we have established a large cohort of Chinese AF patients and provided solid epidemiological data to facilitate everyday management of AF in Chinese. Inspired by the data and realising the huge unmet needs, we initiated a population-based AF screening programme at the primary care setting to screen 60 000 high-risk patients in a hope to reduce AF-related stroke in Hong Kong. We shall discuss the current understanding of stroke prevention in AF in Chinese and share our experience in research and clinical practice to healthcare policy related to AF.