Health: Atrial Fibrillation and Stroke

Lord Black of Brentwood Excerpts

Tuesday 12th December 2017 Lords Chamber

Asked by

[Lord Black of Brentwood]

To ask Her Majesty’s Government how many people with a diagnosis of atrial fibrillation who were admitted to hospital with a stroke in 2016-17 were not on an appropriate anti-coagulation therapy prior to admission.

[The Parliamentary Under-Secretary of State, Department of Health (Lord O'Shaughnessy) (Con)]

My Lords, audit data shows that around half of patients with known atrial fibrillation who have a stroke have not received anti-coagulation treatment before their stroke. Figures for last year show that this varies from 25% in some clinical commissioning group areas to almost 100% in others. More than 300,000 people in England have undiagnosed atrial fibrillation.

[Lord Black of Brentwood (Con)]

I thank my noble friend for that Answer. As he knows, atrial fibrillation is a significant cause of stroke but it is also avoidable, because it is easily diagnosable and easily treatable with anti-coagulant medication. Yet as the figures he just gave us show, more than 7,000 people in England who were admitted to hospital with a stroke last year were known to have AF but were not receiving proper therapy. Is my noble friend aware that the National Clinical Directors for cardiovascular disease prevention and stroke recently stated:

“Failure to prescribe an important treatment”,


such as this,

“needs to be seen as an error that is equally as serious as prescribing the wrong treatment”?

What action can the Government take to ensure that all eligible patients with AF are prescribed anti-coagulation to help protect them from stroke and the devastating consequences that flow from that for them and their families?

[Lord O’Shaughnessy]

I thank my noble friend for making that point. He is quite right that atrial fibrillation is easily diagnosable and treatable. In the end, it has to be a clinical judgment on what kind of medicine is appropriate for any given patient, but the variation in the prescription of anti-coagulants demonstrates that there is not uniform understanding of the options. There are a number of things I could point my noble friend to, such as the NICE guideline which promotes not only self-monitoring systems, which are typically what we have had, but encourage patient choice for the new types of anti-coagulants which have a lower risk of bleeding and are much more popular with patients.