Cone Health Unveils Stroke Research in Berlin
A Cone Health team has found a way to apply the latest stroke research to a wider number of patients. Their research was presented today at the 1st Congress of the European Academy of Neurology in Berlin.
According to the National Stroke Association, about one out of every four every four people who have a stroke will have another. Subsequent strokes may be caused by atrial fibrillation (Afib). That is when the top two chambers of the heart do not fully contract. Blood pools in the chambers forming clots, which can cause strokes. Afib can be challenging to diagnose because the arrhythmia is sometimes sporadic and not all patients have symptoms.
Stroke patients have historically been monitored for Afib for about a month after a stroke using an external event monitor. The Crystal AF study found that long-term monitoring of stroke patients can find many at risk of future strokes. Cone Health doctors developed a protocol to implant loop recorders in patients. The paper clip-sized devices can monitor the heart’s electrical activity for up to three years. “We have shown we can replicate the results of the Crystal AF study in community hospitals,” explains Moses Cone Hospital Stroke Center Medical Director Dr. Pramod Sethi, co-author and presenter of the study. “This gives us a much better chance of uncovering Afib in our patients using longer periods of monitoring. In fact, we find that on average Afib does not appear until 50 days after the initial stroke.”
Electrophysiologist James Allred, along with colleagues Dr. Steven Klein and Dr. Gregg Taylor, implanted loop recorders in 58 stroke patients from March-Dec 2014 at Moses Cone Hospital. They found undiagnosed Afib in 17 percent of them. “Knowing this helped us improve the care we provided those patients,” says Allred who co-authored the study. “In our center, those 17 percent of patients were then initiated on a blood thinner which reduces their chances of another stroke. Developing this program which allows us to monitor patients for longer periods of time will allow us and other community hospitals to provide better care.”
The Cone Health Stroke Center treats an average of 1,300 patients per year and is one of the busiest in North Carolina.