Poor ECG access to limit AF points

GPs without access to ECG will struggle to hit new quality targets for AF, according to GP experts.

The warning came as NICE issued the second draft of its AF guideline that supports the new quality indicators for AF by recommending that all patients with suspected AF should have the diagnosis confirmed by ECG.

The guidelines state that an ECG should be performed on all patients, whether symptomatic or not, in whom a diagnosis of AF is suspected based on the detection of an irregular pulse.

Under the revised quality framework to begin in April, 10 quality points will be allocated to rewarding practices for diagnosing AF with ECG or having a specialist-confirmed diagnosis.

Yorkshire GP Dr Terry McCormack, chairman of the Primary Care Cardiovascular Society, said: 'Ideally, all AF patients should have ECGs because that is the only way to confirm the diagnosis, but not every practice has access to ECG equipment.

'I don't think we should send everyone to a specialist now. That would create a huge workload,' he added.

Treating patients with AF with anti-coagulant or anti-platelet drug therapy will be worth 15 points under the revised quality framework.

www.nice.org.uk

AF GUIDANCE SECOND-DRAFT NICE GUIDELINES RECOMMEND:

- ECG for all AF patients.

- Rate control with beta-blockers or rate-limiting calcium antagonists.

- Anti-thrombotic therapy for patients with persistent AF whether using rate control or rhythm control approach.

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