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Study Suggests Need for More Aggressive Outpatient Monitoring of Patients' Hearts When Cause of Stroke is Unclear
Date:11/19/2008

t people develop. During AF the heart's two upper chambers (the atria) beat chaotically and irregularly. The condition causes poor blood flow and the development of blood clots within the heart which can subsequently release into the arteries of the brain and cause a stroke.

Dr. Tayal said the conventional approach to evaluating stroke patients is an extensive in-hospital diagnostic work-up that includes neurological imaging such as MRI and angiography and cardiovascular studies, such as telemetry and holter monitoring, that assess the heart's rhythm.

"Intermittent AF becomes more common as we grow older and as a known risk factor for stroke, the current standard of care when the cause of injury is unclear is to monitor patients with telemetry for several days in the hospital. Unfortunately, our probability of detecting AF in this brief window of time is less than 1%," Dr. Tayal said.

Using a newer, mobile telemetry system called CardioNet, Dr. Tayal and his AGH colleagues evaluated 56 patients with stroke of unknown etiology and no previous history of AF for a period of three weeks post-discharge. Hospital based telemetry and holter monitoring results for all were normal.

The CardioNet System requires no patient interaction. Via three leads attached to a lightweight sensor worn on a neck strap or belt clip, the monitor analyzes a patient's heart rhythm in real time during normal daily activities. When the system identifies an abnormal rhythm, the data is automatically transmitted to the medical team.

Over the course of three weeks, thirteen of the 56 patients in AGH's study were found to have either prolonged or brief episodes of AF. For those with prolonged incidents -- a clear indication of stroke cause -- the discovery prompted immediate therapeutic intervention with medication designed to better protect the patient from a repeat stroke.

Dr. Tayal sai
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SOURCE Allegheny General Hospital
Copyright©2008 PR Newswire.
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