Atrial Fibrillation Detectable in Patients With Diabetes Through Simple Foot Test

Annual foot assessments for patients with diabetes can detect atrial fibrillation, according to research presented at the European Heart Rhythm Association 2021, an online scientific congress of the European Society of Cardiology. A heart rhythm disorder, atrial fibrillation occurs at least twice as frequently in patients with diabetes as those without.

Annual foot checks are advised for patients with diabetes, as increased blood sugars lead to poor circulation, nerve damage, and numbness. The condition can ultimately lead to foot amputation if these problems go undetected. Atrial fibrillation, for which diabetes is an independent risk factor, leads to a 5 times higher risk of stroke, though anticoagulation medication is an effective preventive therapy.

“The yearly check-up includes palpating the arteries in the feet to examine whether there is healthy blood flow,” said Ilias Kanellos, MD, MSc, in a press release. “During this examination we noticed that some patients had an irregular rhythm and decided to investigate its usefulness for diagnosing atrial fibrillation.”

For the study, 2 podiatrists and 6 podologists were trained to spot rhythm abnormalities during pulse palpation of the foot arteries. They were also shown how to confirm their findings using a hand-held Doppler ultrasound device.

The researchers followed 300 patients with diabetes attending their annual foot screening appointments over the course of 12 months. Patients with rhythm abnormalities during pulse palpation of their foot arteries underwent a Doppler ultrasound to verify the observations.

“In our study, one in six patients with diabetes had previously undiagnosed atrial fibrillation," Kanellos said in the release. "This presents an opportunity to provide treatment to prevent subsequent strokes.”

Fifty-one patients in total were found to have previously undiagnosed atrial fibrillation, in equal proportion between women and men. These patients were then advised to visit a cardiologist for an electrocardiogram to reinforce the diagnosis and discuss treatment.

“The study has identified a simple, quick, and low-cost way to identify patients with diabetes who have a heart rhythm disorder they were unaware of,” Kanellos said in the release. “This intervention has the potential to avoid strokes and preserve quality of life in this patient group.”


Simple foot test detects heart rhythm disorder in patients with diabetes [news release]. EurekAlert; April 24, 2021. Accessed April 26, 2021.