The American Heart Association/American Stroke Association (AHA/ASA) and Medtronic plc have agreed a collaboration to reduce the rate of recurrent strokes in the USA. The two organisations will work together over several years to educate, raise awareness and support effective management of patients who have strokes. The initiative, announced at the American Stroke Association’s annual International Stroke Conference (10–12 February, Nashville, Tennessee) will focus on reducing strokes of unknown cause—cryptogenic stroke.
The most common (87%) type of stroke—ischaemic—occurs when blood vessels carrying oxygen and nutrients to the brain are blocked by a clot causing brain cells to die. Thirty per cent of ischaemic strokes have no known cause (deemed cryptogenic) even when diagnostic tests are performed during a stroke patient’s hospitalisation.
Recent studies have shown that many stroke patients also suffer from atrial fibrillation. Patients with atrial fibrillation are five times more likely to have strokes, but their condition often goes undiagnosed because their atrial fibrillation episodes occur only sporadically and may not have any symptoms. Studies have shown that continuous, long-term cardiac monitoring of cryptogenic stroke patients helps physicians detect and diagnose atrial fibrillation and provide treatment to prevent a recurrent stroke.
“Recent evidence suggests that up to 20% of patients who do not have a cause for their stroke identified while in the hospital may demonstrate evidence of intermittent or paroxysmal atrial fibrillation during weeks to months of extended heart rhythm monitoring,” said Lee Schwamm, American Stroke Association volunteer spokesperson, vice chairman, department of neurology, and director of stroke services at Massachusetts General Hospital. “As the cost and convenience of outpatient cardiac rhythm recorders has improved, they will likely play an increasingly important role in identifying or excluding atrial fibrillation or other arrhythmias in patients with ischaemic stroke. Further research is needed to discern which types of patients benefit most from extended monitoring, and which types and what duration of atrial rhythm abnormalities increase the risk of future stroke.”
“This collaboration between AHA and Medtronic will help to address these critically important topics. As physicians, patients and families become more aware of atrial fibrillation as a potential cause of stroke, and as research confirms the risks associated with these more subtle disturbances, we believe that this could become a game changer in the stroke field in helping us to reduce recurrent strokes, ultimately reducing disability and saving lives,” he said.
The new collaboration will support the AHA/ASA’s goal to reduce death from stroke by 20% by 2020.
“Our stroke prevention collaboration with the AHA was founded on a common goal of improving care for the hundreds of thousands of unexplained stroke patients across the country,” said Nina Goodheart, vice president and general manager of the diagnostics and monitoring business at Medtronic. “Insertable cardiac monitors have been proven to be highly effective for the detection of atrial fibrillation in these patients and when that occurs, clinicians are able to change patients’ treatment course, which can help reduce their risk of suffering a subsequent stroke. Together with AHA, we are committed to conducting more research and education to ensure that clinicians have the appropriate resources to better serve these patients.”