World Heart Day
Virtual Wards offer cardiac patients hospital care at home
Since June 2024, eligible cardiac patients who require in-patient acute care can now avail of a HSE Virtual Ward where they will receive the same expert clinical care and support in the comfort of their homes.
Eligibility for Virtual Wards is determined once a patient is deemed clinically stable and low-risk by their consultant, amongst other factors.
Connected cardiac care with Virtual Wards Virtual Wards have evolved from pressures healthcare systems face in unscheduled care — pressures which increased during the pandemic. For some patients, monitoring by clinical teams harnessing technology can now offer a safe and preferable alternative to hospital admission.
Central to Virtual Wards is the empowerment of patients to be active partners in managing their health and wellbeing. Jim Murphy (60s) from Limerick had a history of irregular heartbeat. Six months ago, his GP referred him to a specialist who carried out an angiogram.
Murphy shares: “They found that I had a blockage in one of my arteries, so I was admitted to University Hospital Limerick for a stent. I was in overnight, and the nurse contacted me offering the Virtual Ward service. They provided all the equipment — a table, a device to monitor blood pressure, my oxygen — it was all connected by Bluetooth and recorded on the tablets. The nurses would message me before
they called. We would have a consultation via video call, and they could examine the surgery wound. It was all very well-connected and responsive.”
Advancing digital healthcare
The new Virtual Ward service has now supported over 170 patients in the participating hospitals (St Vincent’s University Hospital and University Hospital Limerick) and will continue to grow in the coming weeks.
The new Virtual Wards service marks a new and exciting phase of the digital transformation of our health service in line with ‘Digital for Care’ the new Digital Health Framework for Ireland, recently published by the Department of Health. Digital for Care sets out how we can harness the power of digital technology to improve patient access, increase efficiency and ultimately provide better health outcomes and experiences for everyone.
Her heart matters: know the signs of a heart attack
Learn to recognise heart attack symptoms in women. The Her Heart Matters campaign offers tips to prevent heart disease and improve women’s heart health.
One in four women die from heart disease and stroke each year — the same as men. Yet, women are less likely to recognise the symptoms of heart attack. They also take longer than men to get medical help and treatment after experiencing a heart attack.
Start the conversation on heart conditions
The Irish Heart Foundation, supported by the Department of Health and the HSE, has developed the Her Heart Matters campaign to help women look after their hearts. The good news is that 80% of premature heart disease and stroke is preventable through healthy lifestyles. Running throughout September, the campaign provides practical information and supportive tools for women.
If you are concerned about your risk of heart disease, talk to your doctor. You can use the tips on our website to get the conversation started.
Symptoms of heart attack in women
As well as making heart-healthy lifestyle changes, be aware of heart attack symptoms. By knowing what the symptoms are, you can take the steps that can help get timely treatment.
The following symptoms are
common in women: chest pain that spreads to the neck, shoulder and left arm; difficulty breathing; dizziness; vomiting or feeling like you are going to vomit; sweating. Less common symptoms that may occur: back pain; stomach pain; extreme fatigue. Some of these symptoms are common in other health conditions too, so you may not think they could be a heart attack. Don’t ignore them.
What should I do if I think I am having a heart attack?
Call 112 or 999 immediately. A heart attack is a medical emergency — when the supply of blood to your heart is suddenly blocked. The faster you get treatment, the less damage to your heart.
Try to stay as calm as possible while waiting for help to arrive. Taking deep, slow breaths can help. Do not drive yourself to the hospital.
To learn about heart attack and how to protect your heart, visit irishheart.ie
Janis Morrissey Director of Health Promotion, Information and Training, Irish Heart Foundation
Ken McDonald Cardiologist and Clinical Lead, HSE National Heart Programme
Cardiology clinic highlights the importance of lifestyle changes for heart health
To address the growing impact of cardiovascular disease in the Irish community, a cardiac care clinic provides comprehensive diagnostic, preventive and interventional services for managing these conditions.
Each year, over 9,000 people in Ireland lose their lives to cardiovascular disease (Irish Heart Foundation, 2023), with thousands more people living with its life-changing consequences. The burden of cardiovascular disease continues to grow, driven by lifestyle-related factors that, with proper management, could be addressed to improve heart health and save lives.
Lifestyle changes for better cardiac health
Factors such as diet, smoking and a sedentary lifestyle are some of the biggest risk factors for cardiovascular disease. Active smoking and secondhand smoke exposure account for around 30% of deaths from coronary heart disease (Gallucci et al, 2020), and it is thought that over two-thirds of deaths from heart disease worldwide could be prevented with healthier diets (European Society of Cardiology, 2020). According to World Heart Federation statistics, 80% of premature heart disease and stroke are preventable.
Maintaining a balanced diet, staying physically active and avoiding smoking are simple but powerful steps anyone can take. These simple lifestyle adjustments not only reduce the risk of heart disease but also improve quality of life, making them essential tools in combating the epidemic of heart disease in Ireland.
Expert cardiac care in Ireland
Recognising the growing need for specialised cardiac care in Ireland, Lifeline Cardiology Clinic was established to provide a range of cardiac care and treatment services and also create awareness in the community.
Founded by Dr Abid Hussaini, Consultant Interventional Cardiologist with over a decade of clinical experience, the clinic offers comprehensive diagnostic, preventive and interventional services aimed at managing cardiovascular diseases, including hypertension, heart failure, arrhythmias and coronary artery disease.
These include cardiac consultation, resting ECG, echocardiogram, stress testing, 24-hour heart activity monitoring, BP monitoring and sudden cardiac death screening. With state-of-the-art services and personalised care, the team at Lifeline Cardiology Clinic not only offers expert cardiac care but also leads initiatives to promote heart health, raise awareness and improve outcomes for patients in Limerick and surrounding counties.
Know your heart rhythm to save yourself from devastation of AF-related stroke
Currently, up to 30% of individuals who have atrial fibrillation (AF) are undiagnosed and at risk of complications, such as an AF-related stroke. So, it is important to know your pulse to know your heart rhythm.
What is atrial fibrillation?
Atrial fibrillation, or AF, is a heart condition that causes an irregular and often abnormally fast heart rhythm. It is the most common heart rhythm disturbance encountered by doctors, affecting around 1.4 million people in the UK. It can affect adults of any age but is more common as people get older; in the over-65-year-old age group, it affects about 10% of people.
AF causes irregular, rapid heartbeats
A normal heart rhythm should be regular and between 60 and 100 beats a minute when you are resting. In people with AF, it can be considerably higher than 100 beats a minute. This can cause problems including dizziness, shortness of breath and tiredness. You may be aware of noticeable heart palpitations, where your heart feels like it’s pounding, fluttering or beating irregularly — often for a few seconds or, in some cases, a few minutes.
Know your pulse
Typical symptoms such as palpitations, chest pain, shortness of breath, fatigue, dizziness and fainting. However, this does not apply to everyone. Some people experience no symptoms at all and are considered ‘asymptomatic.’ Therefore, it is important to ‘Know Your Pulse to Know Your Heart Rhythm’ — it could save your life. Detecting an irregular pulse is often the only symptom of AF.
Reducing stroke risk and managing symptoms
It is important to reduce the risk of an AF-related stroke with anticoagulation therapy. Treatment for AF aims to restore the heart’s normal rhythm. If that’s not possible, the goal shifts to slowing the irregular heart rate to relieve symptoms.
AF is not a life-threatening heart rhythm problem, but it can be troublesome and often requires treatment.
AF is not a life-threatening heart rhythm problem, but it can be troublesome and often requires treatment. AF is more likely to occur in people with other conditions, such as high blood pressure (hypertension), atherosclerosis or a heart valve problem.
AF increases stroke risk significantly People with atrial fibrillation have a five times greater risk of having a stroke. In some cases, atrial fibrillation can also lead to heart failure. So, it is very important to know the signs, detect AF, protect against AF-related stroke and correct the irregular heart rhythm.
Global AF Aware Week
The AF Association hosts Global AF Aware Week (GAFAW) each year. GAFAW on 18–24 November 2024 aims to raise awareness of AF across the globe so that people can be detected, protected and treated earlier and live healthier and happier lives. Raising awareness of AF is vital for the public to understand the associated dangers, its link to stroke and the importance of a regular pulse rhythm check.
Trudie Lobban MBE Founder, AF Association and Arrhythmia Alliance
Dr Abid Hussaini MBBS, FRCPI, MRCP UK, DIP.CARD, FTTA, Consultant Interventional Cardiologist, Lifeline Cardiology Clinic
Navigating the pathway for cardiac arrhythmia
Arrhythmia detection and management are changing, with new self-referral pathways and arrhythmia Clinical Nurse Specialist clinics for arrhythmia patient management.
Alex Kenny, arrhythmia
Clinical Nurse Specialist at Beacon Hospital, discusses her role in arrhythmia (irregular heartbeat) diagnosis and management. “My role provides a newly established service in which patients can receive sub-specialty care and access to treatment, including a same-day Consultant Electrophysiologist consultation,” she says. “The most prevalent arrhythmias we treat are atrial fibrillation, atrial flutter, supraventricular tachycardia (SVT) and ventricular ectopy.”
Arrhythmia detection with smart devices “We tailor our diagnostics and management based on each patient, with full cardiac assessment including a 12-lead ECG, echocardiogram, exercise stress test, 24 to 72-hour
for cardiac MRI,” explains Kenny. Wearable devices, such as smartwatches, can help increase detection of arrhythmias significantly, particularly in individuals who might otherwise go undiagnosed. “Patients can self-refer to our service based on their symptoms or smart device data, or they can be referred to us by their GP,” she adds. “Smart devices are changing the way heart conditions are detected and diagnosed; there is an increase in patients presenting directly to our clinic as they are now taking more responsibility for their heart health. It’s a useful tool as Cardiologists can now rely on this data to diagnose symptoms.”
Why early detection matters Kenny explains: “Symptoms can include palpitations, an increased/
irregular heart rate above the typical 60–100 beats per minute, fatigue and shortness of breath — but for some people, there may be no symptoms at all.”
Organisations across Ireland promote cardiac screening in young people, especially for those who are asymptomatic or in high-risk groups, such as athletes or those with a family history of arrhythmias. She adds: “Follow-up is a big part of my role; one patient told me that finally getting a diagnosis completely changed her life.”
Treatment options for patients with arrhythmia
“We are lucky to be a technologically advanced hospital, so if there is a way to stop patients from being on long-term drug therapy, we will endeavour to find it,” says Kenny. “We are treating more patients than ever before with catheter ablation, which reduces the number of long-term medications they will require and improves patients’ ongoing quality of life.”
The procedure is not limited on the basis of age, and the success rate is high, according to Kenny. She concludes: “By leveraging the latest in diagnostic tools and treatments, we aim to provide tailored, effective care and enhance the quality of life for our patients.”
New cardiac services available in the South East are improving patient outcomes
As the burden of cardiovascular-related arrhythmias increases, new cardiac services in the South East alongside improved management techniques come at the right time to improve patient outcomes.
The burden of cardiovascular-related arrhythmias in the community is increasing. Factors such as poor diet, alcohol consumption and physical inactivity contribute to an increased risk of developing arrhythmias, alongside genetics, cardiovascular problems and high blood pressure.
Arrhythmia affecting more people
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Atrial fibrillation (AF) is the most common type of cardiac arrhythmia, affecting around 59 million individuals, and is the leading cardiac cause of stroke. Prof Usama Boles, Consultant Electrophysiologist and Cardiologist, discusses the extent of the issue: “We are seeing younger and younger people present with arrhythmias, individuals leading highstress lives, whether in their jobs, studies or personal circumstances — or athletes who regularly engage in intense physical training.”
Critical early detection
arrhythmia diagnosis and treatment. Their expertise is essential in managing arrhythmias effectively, utilising advanced technologies and personalised strategies to improve patient outcomes.
“Electrophysiologists facilitate in-depth investigation and prediction of arrhythmia risk using specialised tools,” explains Boles. “Additional investigations, such as comprehensive echocardiograms and advanced management strategies, are key to understanding the extent of the disease and guiding treatment plans.”
Electrophysiologists are medical specialists dedicated to arrhythmia diagnosis and treatment.
With a range of symptoms including palpitations, shortness of breath, lack of energy and fatigue, cardiac arrhythmias can significantly impact a person’s daily life. Early intervention is critical to preventing complications.
“In an audit done in the East of Ireland, 41% of strokes were attributed to AF; immediate assessment is required to start the patient on stroke prevention medications,” Boles says. “The earlier we can intercept cardiac arrhythmias and begin appropriate management, the better the outcome.”
Role of the electrophysiologist
Electrophysiologists are medical specialists dedicated to
Changing face of treatment
Ablation, a procedure to destroy abnormal heart tissue causing arrhythmia, has improved significantly. It is becoming more effective and efficient with fewer complications and shorter recovery times. “There is a massive improvement in what we can provide. Ablation is becoming the first-line treatment in many situations and is more widely available, enabling us to offer life-changing interventions to more people,” says Boles.
Alongside the risk of stroke, AF can cause additional health complications, making ablation a powerful solution to manage and even eliminate symptoms. “We have various pathways, with rapid access arrhythmia clinics in public and private sectors, ensuring we can fast-track people with high risk, where all available treatment options are discussed,” he continues.
UPMC Whitfield Hospital now offers electrophysiology studies and catheter ablation for South East residents, allowing them to access these services closer to home.
Prof Usama Boles Consultant, Electrophysiologist and Cardiologist, UPMC Ireland
Alex Kenny
Arrhythmia Clinical Nurse Specialist, Beacon Hospital
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Bethany Cooper
Bethany Cooper
What you need to know about heart failure prevention, diagnosis and management
Discussing heart failure (HF) can feel daunting due to its negative connotations. However, advances in treatment inspire hope, shifting focus towards heart function — not failure — to foster more constructive conversations.
Heart failure is a serious condition with varying severity, indicating the heart’s inefficient pumping and circulation.
Early HF diagnosis enhances prognosis
Common symptoms include breathlessness, such as reduced ability to exercise and fluid retention or swelling in the ankles, legs or abdomen. Early diagnosis is key to improving patient prognosis long-term to enable prompt treatment of the condition. This ambition is driven by the major advancement in drugs and devices available to treat the condition in recent years that are proven to reduce hospitalisation and improve prognosis.
Preventing HF through risk management
As important as treating the condition is prevention. The American Heart Association describes this well through their classification of HF as four stages (from A–D). Stage A incorporates those with risk factors for the development of HF but no structural abnormality of the heart, reminding us the condition is often preventable. The diagnosis and treatment of cardiovascular risk factors that often prevent the condition of HF — such as high blood pressure, high cholesterol and obesity — cannot be underestimated.
Blood pressure control
pressure is one of the most effective ways to preserve our health against a multitude of serious medical conditions such as heart disease, stroke, kidney disease and vascular dementia. As reflected by the recent European Society of Cardiology, treatment of high blood pressure is not confined to older patients. The long-term changes resulting from persistently high circulatory pressures can cause complications to heart function, kidney function and brain function down the line. These complications are generally preventable by ensuring your blood pressure is within normal range.
Treating high blood pressure is one of the most effective ways to preserve our health.
From a population perspective, treating high blood
A 75-year journey in transforming all-Ireland cardiac care
Discover a legacy in advancing cardiovascular health through groundbreaking research, education and advocacy.
At the Irish Cardiac Society, we will be celebrating our 75th anniversary. The Society was established on an all-island basis, and the inaugural meeting was held at St Vincent’s Hospital, Dublin on 3 November 1949.
Advancements in cardiac care and research
During the 1950s, the Society expanded. Of note, several members who had worked outside Ireland returned with specialist skills. In the 1960s, the Society formally became a constituent member of the European Society of Cardiology. Prof Risteard Mulcahy, (President, 1965–66) instigated the creation of the Irish Heart Foundation. At that time, Prof Frank Pantridge and his colleagues established mobile coronary care and undertook groundbreaking research to develop portable defibrillators. The 1970s–1990s saw the widespread introduction of cardiac imaging, percutaneous coronary interventions and cardiac rehabilitation. Over the past 20 years, members have contributed to the rapid expansion of subspecialty training in electrophysiology, cardiac imaging, heart failure, inherited cardiac conditions and structural heart disease. Key
Integrated cardiovascular care for patients
Through the Irish Chronic Disease Management programme, patients with common cardiovascular conditions such as high blood pressure or high cholesterol can sign up for a GP check-up twice yearly to monitor risk factors in an effort to maintain long-term good health.
Linking in with this programme is the national integrated cardiovascular care service. This programme improves GP access to cardiac diagnostics, including echocardiograms and specialist care, in non-hospital settings. With nurse-led education, it aims for prompt diagnosis and treatment of conditions like heart failure, atrial fibrillation, high cholesterol and high blood pressure, adopting a patient-centred approach to enhance long-term outcomes.
recent developments include the introduction of community-based cardiology services, technology-enhanced delivery of care and all-island networks, for example in paediatric cardiology.
New cardiac strategy with education
In 2022, the Irish Cardiac Society developed a new strategy, with five main pillars, including education, registries, research, advocacy and corporate governance. Education is a core activity, whereby we offer access to training support and educational events. We also focus on maintaining strong international partnerships with the British Cardiovascular Society, the European Society of Cardiology, the American College of Cardiology and the World Heart Federation. We encourage our trainees to undertake Fellowships outside of Ireland, so they can bring back their enhanced knowledge and skills for our population’s benefit.
Advocacy for cardiovascular health
We recognise the importance of advocacy to ensure optimal cardiovascular health and wellbeing. We are delighted that, on 4 July
2024 at a high-level EU Ministerial conference hosted by the Hungarian Presidency in partnership with the European Society of Cardiology, representatives from Ministries of Health discussed the need to improve cardiovascular health in Europe as well as prioritisation of cardiovascular health plans at both a national and European level.1
This is a milestone on our collective journey to make cardiovascular health a political priority and aligns with the work undertaken by the World Heart Federation. The Irish Cardiac Society looks forward to supporting its members over the next 75 years and will continue to advance cardiology to improve the population’s cardiac health.
Reference 1. https://www.escardio.org/static-file/Escardio/Advocacy/ health%20policy/2024_CVH_Concept_Paper.pdf
Professor Pascal McKeown President, Irish Cardiac Society
The Irish Cardiac Society 75th Annual Scientific Meeting will take place at the Europa Hotel, Belfast from 17th–19th
Ciara Cahill Cardiovascular Clinical Nurse Specialist for CHO3, University Hospital Limerick
Dr Neasa Starr Consultant Cardiologist UHL & Mid-West Integrated CV Care, University Hospital Limerick
Sponsored by University Hospital Limerick