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NICE guidance supports new blood pressure device that can detect atrial fibrillation

New NICE medical technologies guidance published today (16 January), supports the use of a device that can detect atrial fibrillation whilst blood pressure is being measured.

Using WatchBP Home A in the NHS for opportunistically detecting asymptomatic atrial fibrillation during the measurement of blood pressure by primary care professionals, is backed by the NICE guidance. The recommendations note that using WatchBP Home A could increase the detection rate of atrial fibrillation, which would allow preventative treatment to be given to reduce the incidence of atrial fibrillation-related stroke.

The guidance also recommends that WatchBP Home A should be considered for use in people with suspected hypertension (high blood pressure) or those being screened for hypertension in primary care. People with suspected atrial fibrillation should have an electrocardiogram (ECG) in line with NICE clinical guideline 36, Atrial fibrillation.

Hypertension is defined by a consistent blood pressure reading on different occasions of 140/90mmHg or higher. If left untreated, high blood pressure increases the risk of a heart attack or stroke. Atrial fibrillation is a heart condition that causes an irregular and often abnormally fast heart rate, and is the most common heart rhythm disturbance. It can lead to dizziness, shortness of breath and palpitations, but some people have no symptoms and so are not aware that their heart rate is irregular.

The WatchBP Home A device is a blood pressure monitor which automatically detects pulse irregularity that may be caused by symptomatic or asymptomatic atrial fibrillation, whilst it records blood pressure. Blood pressure is taken using a cuff which fits around the upper arm, and which is connected to a small unit which records the reading. The monitor can be used for diagnosing hypertension in a clinical setting with the measurement taken under the supervision of a clinician.

Professor Carole Longson, Director of the NICE Centre for Health Technology Evaluation, said: "We are delighted to publish this new guidance supporting the use of Watch BP Home A for picking up atrial fibrillation whilst blood pressure is being measured in some people. The evidence considered by the independent Medical Technologies Advisory Committee (MTAC) indicates that the device can offer advantages in detecting atrial fibrillation opportunistically whilst measuring blood pressure, and that using the device in primary care could increase the detection rate of atrial fibrillation compared with taking the pulse by hand. This would allow preventative treatment to be considered to reduce the incidence of atrial fibrillation-related stroke. The guidance is not about screening for atrial fibrillation, but about the benefits that the device offers in helping to pick up atrial fibrillation by chance in people with suspected high blood pressure or those being screened for high blood pressure, in primary care.

"Using WatchBP Home A is associated with estimated overall cost savings per person screened of between £2.98 and £4.26 for people aged 65 or over, depending on their age. This guidance will give the NHS confidence in deciding whether to introduce the WatchBP Home A device to help detect atrial fibrillation in specified groups of people who are having their blood pressure taken."

The medical technology guidance “WatchBP Home A for opportunistically detecting atrial fibrillation during diagnosis and monitoring of hypertension” is available at www.nice.org.uk/MTG13 .

ENDS

Notes to Editors

About the guidance

1. The medical technologies guidance, “WatchBP Home A for opportunistically detecting atrial fibrillation during diagnosis and monitoring of hypertension”, is available at www.nice.org.uk/MTG13 from Wednesday 16 January. Please contact the NICE press office for an embargoed copy.

2. The WatchBP Home A device is manufactured by Microlife.

3. Use of WatchBP Home A in primary care is associated with estimated overall cost savings per person measured ranging from £2.98 for those aged between 65 and 74 years to £4.26 for those aged 75 years and over. There is uncertainty about the costs and benefits for people under 65 years of age, however it is plausible that using the device in this group will benefit patients and the healthcare system. Cost analyses did not support the use of the device by patients in their homes.

4. The average cost of the WatchBP Home A device stated in the sponsor's submission is £75 (excluding VAT).

5. Atrial fibrillation is a heart condition that causes an irregular and often abnormally fast heart rate. It is the most common heart rhythm disturbance, affecting up to 800,000 people in the UK.

About the Medical Technologies Evaluation Programme

6. Established by NICE in 2009, the focus of this area of work is specifically on the evaluation of innovative medical technologies, including devices and diagnostics. The types of products which might be included are medical devices that deliver treatment such as those implanted during surgical procedures, technologies that give greater independence to patients, and diagnostic devices or tests used to detect or monitor medical conditions. The independent Medical Technology Advisory Committee has two core remits: selecting medical technologies for evaluation by NICE guidance programmes and also developing medical technologies guidance itself. The guidance applies to the NHS in England, and is not mandatory.

More information about the Medical Technologies Evaluation Programme

About NICE

7. The National Institute for Health and Care Excellence (NICE) is the independent organisation responsible for providing national guidance and standards on the promotion of good health and the prevention and treatment of ill health.

8. NICE produces guidance in three areas of health:

  • public health - guidance on the promotion of good health and the prevention of ill health for those working in the NHS, local authorities and the wider public and voluntary sector
  • health technologies - guidance on the use of new and existing medicines, treatments, medical technologies (including devices and diagnostics) and procedures within the NHS
  • clinical practice - guidance on the appropriate treatment and care of people with specific diseases and conditions within the NHS.

9. NICE produces standards for patient care:

  • quality standards - these reflect the very best in high quality patient care, to help healthcare practitioners and commissioners of care deliver excellent services
  • Quality and Outcomes Framework - NICE develops the clinical and health improvement indicators in the QOF, the Department of Health scheme which rewards GPs for how well they care for patients
  • CCG Outcomes Indicator Set (formerly known as COF) - NICE develops the potential clinical health improvement indicators to ensure quality of care for patients and communities served by the clinical commissioning groups (CCGs.

10. NICE provides advice and support on putting NICE guidance and standards into practice through its implementation programme, and it collates high quality guidance and evidence-based information to help professionals deliver the best patient care through NHS Evidence.

This page was last updated: 15 January 2013

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Copyright 2014 National Institute for Health and Care Excellence. All rights reserved.