Over 1.6 million people in the UK are diagnosed with atrial fibrillation (AF). Another 500,000 have yet to be diagnosed. Living with AF increases your risk of stroke.

Without a diagnosis, you are at high risk of an AF-related stroke, which is often fatal. Yet, how many people realise that it is as important to know that your heart is in rhythm as it is to know your heart rate?

AF-related stroke

A deadly cause of stroke is atrial fibrillation – the most common irregular heart rhythm disorder (arrhythmia).

AF is so simple to detect. A manual pulse check or use of the latest apps on your watch or mobile phone can detect an irregular heart rhythm. The sooner you detect and seek a diagnosis, the greater the chance of receiving anticoagulation therapy to reduce the risk of AF-related stroke.

The sooner you detect and seek a diagnosis,
the greater the chance of receiving
anticoagulation therapy to reduce
the risk of AF-related stroke.

Pulse field ablation

It is also important to be aware of and access the latest treatment options. Most recently, NICE have approved Pulse Field Ablation (PFA), which, in studies, has proven to have the greatest success rates for people with an early diagnosis following the onset of AF and speedy PFA treatment.

PFA can be performed under local sedation, takes less time than regular ablation techniques, and for many, they can return home the same day. Less time in hospital saves costs to the NHS. Importantly, early treatment with PFA has shown that for many, their hearts are restored to a normal rhythm, and they can lead active lives once again without the fear of AF-related stroke, heart failure and other side effects of AF.

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We are making significant strides in tackling cardiovascular disease — one of our most urgent health challenges.

Thanks to sustained efforts and innovation, we’re seeing real progress. My Department and I remain committed to delivering a comprehensive national cardiovascular strategy.

Cardiovascular disease burden

Cardiovascular disease sadly remains a leading cause of death, with nearly 9,000 lives lost annually, and those left behind devastated by the premature death of a mother or father, grandparent or close relative, when the science says it is largely preventable. Up to 80% of cases can be avoided through healthier lifestyle choices and risk factor detection.

However, there are reasons for optimism. Heart attack rates are falling, thanks to earlier detection, healthier living and rapid emergency response. In 2022 and 2023, nearly 80% of patients with acute heart attacks who went directly to a specialised centre received timely treatment. Stroke care has also improved, with faster assessments and quicker access to brain scans.

Heart attack rates are falling, thanks
to earlier detection, healthier living
and rapid emergency response.

Modernising cardiovascular care

In April, I visited St. Vincent’s University Hospital to see the impact of their innovative Virtual Ward — a consultant-led, nurse-managed service that allows patients with heart failure and other chronic conditions to receive acute care at home. Since its launch in July 2024, it has treated over 523 patients, saved 3,820 bed days and significantly improved outcomes.

Ireland is aligned with EU efforts to prioritise cardiovascular health. Our National Review of Cardiac Services and the National Stroke Strategy is our roadmap for modernising care. The GP Chronic Disease Management (CDM) Programme is delivering measurable results.

The third report of the Programme, published in May 2025, showed that by 31st December 2023, 97% of GP practices nationwide were signed up to deliver the Programme and over 405,000 patients were enrolled to the CDM Treatment Programme. Of those patients, 14% of smokers had quit by their third visit, and average blood pressure levels are falling across the cohort.

Technology is enhancing care through advanced imaging virtual wards and AI using decision support software to guide acute stroke treatment. Community Cardiovascular Specialist Teams are reducing hospital admissions by delivering care closer to home. Public awareness campaigns like FAST are helping people recognise stroke symptoms earlier.

Equitable heart health for all

We know women have specific cardiovascular risk factors and can experience different symptoms from men, which is why we have funded nine innovative projects through the Women’s Health Action Plan.

In March, I launched three UCD-led projects in partnership with St. Michael’s and St. Vincent’s hospitals. These initiatives aim to personalise risk assessments and identify early signs of heart failure. These projects will deliver significant evidence, helping us define and design gender sensitive cardiac services that increase equity in Irish cardiovascular health.

Cardiovascular health is important to everyone. Through innovation, prevention and continued investment, we are building a healthier future for all.

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Heart failure is one of Ireland’s deadliest chronic conditions, with a five-year mortality rate higher than for most cancers.

An Irish Heart Foundation research participant shared: “It’s like your entire being is being sucked out of you. It’s like your soul is leaving you.” These words starkly illustrate the daily struggle of living with heart failure – a condition that can be highly disabling and yet almost invisible to other people.

Heart failure symptoms

For those living with it, heart failure can cause severe physical symptoms, including breathlessness, chronic fatigue and lack of mobility, along with anxiety, depression and post-traumatic stress disorder. However, with the right services and supports, heart failure patients can continue to live full and active lives.

Clinical services for patients with heart failure

Clinical services have improved dramatically in recent years. Yet, the sheer scale of heart failure – which affects over 100,000 people countrywide – means the practical, social, emotional and informational support needs of patients often go unmet.

To bridge this gap, the Irish Heart Foundation has developed a phone-based Heart Connect Service to support patients in their homes. Regular support calls help them cope with the psychological impact and reinforce education around symptom management. There is also access to counselling, our nurse-run support line, online peer support group and programmes ranging from online physical activity sessions to mindfulness.

Cardiac rehabilitation can reduce
heart patient deaths by at least 20%.

Ways to better support heart failure patients

More is needed, however, and the Irish Heart Foundation is lobbying for improvements in the following key areas:

• Almost half of heart failure patients experience depression, but just a handful of Irish hospitals provide access to psychological support, which should be available to all.

• The vast majority incur higher medical, household, travel and other costs while almost half of those we surveyed suffered a significant drop in income. They need help to avoid financial hardship, and working-age patients need support to return to work where possible.

• Cardiac rehabilitation can reduce heart patient deaths by at least 20%, but these services are severely under-resourced, with waiting lists of up to two years. Every patient should have access to high-quality and timely rehabilitation.

• Over a quarter of heart failure patients we surveyed feel abandoned after hospital discharge, while one third feel isolated. Every patient should have the right of access to support programmes, such as those provided by the Irish Heart Foundation.

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Amyloidosis is a group of disorders caused by the build-up of an abnormal protein, amyloid, in multiple organs, leading to dysfunction. The two most common forms are light chain (AL) and transthyretin (TTR) amyloidosis. 

Transthyretin is produced in the liver and normally carries thyroid hormone and vitamin A. In TTR amyloidosis, the protein becomes unstable and forms amyloid fibrils. These can build up in nerves, causing neuropathy and/or the heart, making it thicker, stiffer and less efficient at pumping. 

Two main types of TTR amyloidosis 

The two main types are wild-type and hereditary. Wild-type TTR amyloidosis is the most common form and typically occurs in people as they age, and it is not genetic. Hereditary TTR amyloidosis results from changes in the TTR gene and tends to present earlier, often in the 50s or 60s. Ireland has a native form of hereditary TTR amyloid, T60A — sometimes called ‘Donegal Amy’ as it is more prevalent in families originally from the northwest. 

What are the common symptoms? 

The heart and nervous system are the most commonly involved organs. Symptoms are often subtle at first and can be mistaken for other common conditions, leading to delays in diagnosis. These include: 

• Shortness of breath, especially during physical activity or when lying down; 
• Swelling in the legs or abdomen 
• Fatigue 
• An irregular heartbeat or palpitations 
• Dizziness associated with low blood pressure 
• Altered bowel habit with weight loss 
• Carpal tunnel syndrome 

In hereditary disease, nerve involvement in the hands and feet is common, causing pain, numbness or tingling that may precede cardiac symptoms. 

Early diagnosis and treatment can make
a significant difference in improving
symptoms and limiting the
progression of the condition. 

How is it diagnosed? 

Diagnosis involves a combination of physical examination, specialised blood tests to rule out a bone marrow problem and cardiac imaging (including an echocardiogram or cardiac MRI and a nuclear test called a DPD scan). 

A small number of patients will need a biopsy to help make the diagnosis or specialised nerve testing to assess for nervous system involvement. Once the diagnosis is made, genetic testing is recommended to determine whether the hereditary form is present. 

What treatments are available? 

While TTR cardiac amyloid was once considered untreatable, major advances in recent years have led to treatment options that slow the progression of the disease and improve quality of life and are now available to patients in the Republic of Ireland. 

Treatments include oral medication that stabilises the transthyretin protein or an injectable drug that reduces its production, preventing further amyloid build-up. Patients in Ireland now have the opportunity to take part in clinical trials of promising new treatments, including gene editing for those with the condition, as well as a treatment to delay amyloid build-up in those who carry a gene that puts them at risk. 

Support and specialist clinics for amyloidosis 

In cases of hereditary TTR amyloid, family members are encouraged to meet with a genetic counsellor who can advise about family screening. If you or a family member has been diagnosed or suspected of having transthyretin cardiac amyloidosis, speak with your GP or cardiologist about referral to a specialist amyloid clinic. 

Early diagnosis and treatment can make a significant difference in improving symptoms and limiting the progression of the condition. 

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Transthyretin (TTR) amyloidosis presents with a wide range of symptoms, meaning that patients often consult multiple specialists. Unfortunately, delays in diagnosis remain a challenge. 

Many TTR amyloidosis patients experience symptoms for years before receiving a diagnosis, by which time their condition is often advanced and harder to treat. To address this, a group of clinicians formed a Working Group to develop an Amyloidosis Model of Care, which was approved in 2022. The goal is to reduce diagnostic delays, expedite access to treatment and improve patient outcomes. 

Presenting TTR amyloidosis symptoms 

• Neurological: Peripheral neuropathy (numbness, tingling, pain, weakness), Autonomic neuropathy (orthostatic hypotension, diarrhoea, erectile dysfunction, impaired bladder and bowel control), Carpal tunnel syndrome, Spinal stenosis 
• Cardiac: Cardiomyopathy (heart failure, arrhythmias) 
• Gastrointestinal: Nausea, diarrhoea, constipation, weight loss 
• Musculoskeletal: Joint pain, biceps tendon rupture 

Exciting new therapies are on
the horizon, offering hope for
even better treatment options. 

Advancements in treatment 

Until October 2021, Ireland had no disease-modifying treatments for TTR amyloidosis. Management was symptomatic, aiming to relieve symptoms as best as possible. Patients experienced a gradual and relentless decline, typically succumbing to the disease 5–10 years after symptom onset due to heart failure, autonomic dysfunction and weight loss. 

Thankfully, major treatment advances have changed the outlook for patients. Several medications now alter the natural history of the disease, such as tafamidis and genetic therapies including patisiran, vutrisiran and inotersen. 

These therapies have been life-changing for many patients. While the primary aim of treatment is to stabilise the condition and slow progression, some patients experience improvements, particularly in autonomic or sensory symptoms. Early treatment initiation leads to better outcomes. 

Multidisciplinary care approach 

Managing TTR amyloidosis effectively requires close collaboration between cardiologists and neurologists to tailor treatment plans. At Tallaght University Hospital’s Neuropathy Clinic and the Mater University Hospital’s Cardiac Amyloidosis Clinic, working as part of the Model of Care proposed Irish Expert Amyloidosis Network, Professor Joyce and I conduct regular multidisciplinary amyloidosis meetings. These sessions enable us to discuss cases and determine the most appropriate treatment strategy for each patient. 

Future directions and ongoing research 

TTR amyloidosis research is evolving rapidly. An upcoming trial aims to investigate whether treating pre-symptomatic TTR mutation carriers can delay disease onset. Additionally, exciting new therapies are on the horizon, offering hope for even better treatment options. 

The landscape of TTR amyloidosis treatment has shifted dramatically. Just a few years ago, we had few therapeutic options to offer patients. Today, the field is advancing at an unprecedented pace, bringing real hope to those affected. 

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Insights from genetic testing can shape patient care, treatment selection and preventative healthcare strategies. Consultant Geneticist, Anders Bojesen, speaks to the importance of genetic testing in cardiovascular care.

Genetic testing has emerged as a powerful tool for the assessment of individual risk for inherited cardiovascular disease, guiding preventative measures and potentially saving lives.

Genetics guiding prevention

“Our understanding of how genes impact disease has grown exponentially over the last decade,” explains Anders Bojesen, Consultant Geneticist. “Genetic testing can help with diagnosis and prognosis, treatment decisions and facilitate truly personalised medicine.”

Genetic testing is especially important where a family history of early cardiac death or unexplained cardiac events is concerned. “Conditions such as cardiac arrhythmias, cardiomyopathies and familial hypercholesterolemia can all have a genetic basis,” explains Bojesen. “Genetic testing identifies gene variants, such as the LDL receptor, allowing all family members to be tested and preventative measures to be taken.”

Barriers and opportunities in Ireland

While the National Genetics and Genomics Office (NGGO) is seeking to implement a National Strategy for Accelerating Genetic and Genomic Medicine in Ireland, it is still currently in development. Approximately 20,000 genetic tests in Ireland are still being sent abroad to over 80 different laboratories globally, with long turnaround times leading to delayed results and elevated financial implications. 

“It’s crucial to keep testing local,” implores Bojesen. “Without local services, genetic knowledge isn’t developed nationally. With a single accredited Irish provider and the right capacity, tests can be handled locally, which would be a stark improvement from the existing fragmented system.”

Conditions such as cardiac
arrhythmias, cardiomyopathies
and familial hypercholesterolemia
can all have a genetic basis.

Equal access to genetic insight

Genseq, the largest genomics laboratory in Ireland, provides ISO 15189-accredited clinical genetic testing services to healthcare professionals, alongside a range of genomic solutions. With expertise across the therapeutic areas of cardiology, neurology, nephrology, ophthalmology and oncology, the organisation is passionate about improving local access to valuable genetic insight.

“It’s about equal access to genetic testing. Faster results mean patients aren’t waiting to commence treatment, which improves clinical outcomes,” concludes Bojesen. “Genetics is a powerful tool in cardiovascular care. It’s not just about individual treatment; it’s about prevention, family health and building knowledge locally, so we can continue advancing patient care in Ireland.”

From patient health to national health

With a turnaround time of between one and two weeks for single gene tests, and three to six weeks for panel tests, Genseq is enhancing patient care across Ireland, providing rapid results, timely clinical intervention and building local expertise for patients and their families throughout Ireland.

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Justine Gray

CORU Registered Senior Dietitian, Mater Private Network, Cork, representing the Cardiology Dietitians subgroup of the Irish Nutrition & Dietetic Institute

One of the major risk factors for heart disease and stroke is high cholesterol. Encouragingly, research shows that 80% of premature heart disease and stroke is preventable through lifestyle.

When it comes to diet, the focus should be on eating patterns rather than single foods or food groups.

Reducing the risk of cardiovascular disease

The Mediterranean-style eating pattern has a large body of evidence to support reducing the risk of cardiovascular disease. This pattern of eating is beneficial because it is naturally rich in fibre, phytochemicals, plant sterols, unsaturated fats such as omega-3s, which, when combined, help to lower cholesterol, regulate blood pressure and support healthy blood glucose levels.

Maintaining heart health is about
making healthy food choices that are
realistic and sustainable in the long term

Eating well for heart health

• Include a variety of fruit and vegetables (minimum of five to seven servings per day).
• Eat heart-healthy fats: olive or rapeseed oils, nuts, seeds and oily fish
• Limit intake of saturated fats like full-fat dairy, fatty meats and meat products, cakes, biscuits and pastries.
• Choose wholegrain versions of bread, rice and pasta. Include cereals like oats and barley.
• Eat fish at least twice per week, with one being oily fish.
• Limit salt intake from processed red meats and ready-made meals. Choose lower salt versions of everyday foods such as bread and breakfast cereals. Use herbs and spices instead of salt to flavour food.
• Alcohol: there is no completely safe level. If you drink alcohol, it is important to keep within the low-risk guidelines.

Heart-healthy food swaps

Fats and oils: Butter on bread can be substituted with hummus, nut butter, low-fat soft cheese, pesto or olive tapenade.

Salty foods: Instead of processed meats (like bacon, sausages, ham), have fresh meat, poultry, fish and eggs.

Wholegrains: White bread can be swapped out for high-fibre wholegrain or whole-wheat bread.

Breakfast cereal: Instead of high salt or sugar cereals, have some porridge, overnight oats or shredded wheat.

Realistic and sustainable food choices

Ultimately, maintaining heart health is about making healthy food choices that are realistic and sustainable in the long term. Focus on one small change at a time.

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Irish hospital works towards becoming a centre of excellence for electrophysiology in the public sector, delivering innovation, advancing patient outcomes and setting new standards in cardiac care.

Beaumont Hospital continues to set new standards in cardiac care, establishing itself as a leader in advanced electrophysiology (EP) services within the public health system.

Modern atrial fibrillation treatment

Our team is proud to have performed the first public hospital pulsed field ablation (PFA) case in Ireland using the Boston Scientific Farapulse system. This innovative technology allows us to treat atrial fibrillation patients more efficiently and with enhanced safety, offering shorter procedure times and reduced risk.

The addition of PFA is a major boost to our atrial fibrillation service, which also features same-day discharge protocols and adedicated atrial fibrillation clinic, where Advanced Nurse Practitioner Stephen Byrne plays a vital role in delivering expert, patient-focused care.

We are recognised as the highest-volume public
hospital centre for conduction system pacing.

Advancing heart pacing care

In addition to advancing ablation therapy, we are recognised as the highest-volume public hospital centre for conduction system pacing.This specialist pacing technique preserves the natural function of the heart and lowers the risk of heart failure in selected patients requiring pacemaker implantation.

Reflecting our expertise, Beaumont has been chosen as the national launch site for multiple conduction system pacing technologies from Medtronic, Biotronik and Abbott. We are also the largest public hospital provider of leadless pacemakers — a state-of-the-art option that eliminates the need for traditional pacing leads, improving both safety and long-term outcomes.

Expanding complex electrophysiology care

A cornerstone of our growth has been the use of intra-cardiac echocardiography and zero-fluoroscopy techniques, enabling greater precision while minimising radiation exposure for patients and staff. These advances have allowed us to increase our volume of complex EP procedures, ensuring more patients benefit from timely, cutting-edge treatment.

The success of Beaumont’s EP service is underpinned by innovation, collaboration and patient-focused practice. With continued investment in physiologist and nursing teams, strengthened anaesthetic support and enhanced cardiology infrastructure, we are laying the groundwork to expand services even further. These developments ensure that patients benefit not only from advanced therapies but also from a seamless, multidisciplinary model of care.

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Women are six times more likely to die from heart disease and stroke than from breast cancer, but the condition continues to be under-researched, under-diagnosed, and under-treated in women.

Cardiovascular disease is a leading cause of death among women, claiming the lives of one in four. Yet, awareness remains alarmingly low. The Irish Heart Foundation has developed the Her Heart Matters campaign to help women look after their hearts. Its mission is to empower women to take control of their heart health and reduce their risk of cardiovascular disease through awareness, early detection and lifestyle changes.

Heart-healthy habits for her

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 to build confidence in looking after their heart health.

As part of the Her Heart Matters campaign, women can sign up to receive a free 28-day planner full of practical ideas to build heart-healthy habits into their day. The Irish Heart Foundation has also created a free Self-Care and Wellbeing Journal to support women to reflect on their lifestyle habits and prepare for meaningful and sustainable change.

Heart disease doesn’t always look
the same in women as it does in men.

Know the symptoms

Heart disease doesn’t always look the same in women as it does in men. Symptoms can be subtle and are often overlooked. That’s why early detection and management of risk factors — such as high blood pressure, high cholesterol, smoking and physical inactivity — are critical. Knowing the signs and speaking to a GP about heart health could save lives.

Talk, share, empower

The campaign is not just for women; it’s for everyone who cares about them. Whether it’s your mother, sister, partner or friend, you can play a role. Talk to the women in your life about heart health. Share the facts. Encourage them to make small, sustainable changes like eating healthier, moving more and managing stress.

Women are also encouraged to participate in or organise community events, use campaign resources and spread the word.

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A digital health centre is advancing coronary care through a multidisciplinary, open innovation centre with associated clinical living labs in local hospital settings.

The Centre for Digital Healthcare Technology (CDHT) in Belfast is uniting academia, industry and clinicians to advance coronary care through cutting-edge digital medical technologies. Backed by a £42 million investment via the UK Government’s Belfast Region City Deal and led by Ulster University, CDHT prioritises user-centric design in its innovations.

Building on a legacy in engineering, biomedical and computing sciences, CDHT has developed technologies including portable defibrillators, cardiac monitors and diagnostic systems for heart failure, leading to spin-out success. The Centre is creating a hub for innovation in diagnostics, wearables, active assisted living (AAL), healthcare IoT, implantables, AI, digital twins, Healthcare 4.0 and additive manufacturing.

Industry responds with enthusiasm

Partners such as Dell Technologies are working with CDHT on scalable, secure digital tools for a connected future in care. Local spin-out PulseAI sees the Centre as a platform for responsible, AI-powered cardiac diagnostics that bridge academic research with clinical application. CDHT also collaborates with established centres like EPSRC-PBIAA, BTIC, ARC, FMI and NIBEC.

The CDT is the ideal platform
to cultivate highly skilled
digital health researchers.

Developing future talent

Tech4Health Centre for Doctoral Training (CDT) launched in January 2025 to prepare the next generation of digital health leaders. The CDT focuses on industry-led, PhD projects to develop real-time health solutions for coronary and broader health and care challenges. Through its partnership with University College London (UCL), Ulster offers tailored collaborations to meet both clinical and commercial needs.

“The CDT is the ideal platform to cultivate highly skilled digital health researchers. Our strategic partnership with UCL strengthens our shared expertise in healthcare technology,” says Professor Dewar Finlay, Co-Director, EPSRC Centre for Doctoral Training in Digital Health Technologies Tech4Health.

Global opportunities in heart health

Professor McLaughlin, Professor of Biomedical Engineering, adds: “CDHT is well-positioned to meet growing demands in heart health by promoting co-designed, clinically integrated solutions. The Centre is actively seeking European and international collaborators, presenting strong opportunities for foreign direct investment (FDI) and streamlined access to UK and global healthcare markets.”

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