Know Your Pulse Post Stroke-Measurement of Peripheral Pulse for Detection of Atrial Fibrillation After Ischemic Stroke
Recruitment status was Recruiting
Atrial fibrillation (AF) is the most common cause of cardioembolism and a leading cause of ischemic stroke. The diagnosis of AF after cerebral ischemia is difficult to establish even during the treatment at specialised stroke units, as paroxysmal episodes may terminate spontaneously before arrival at the hospital and do not always show early recurrence. However, the diagnosis of AF is of particular clinical relevance since adaequate anticoagulation is one of the most effective secondary preventive treatments in stroke. The detection rate of AF after stroke increases progressively by extending the duration and intensity of cardiac monitoring. For this purpose innovative medical devices and implantable event recorders have been suggested. However, high socioeconomic expenses, malcompliance and the invasiveness of some of these approaches currently limit their use to a minority of affected patients, while the growing number of stroke survivors is lacking access to free and simple screening tools.
For primary prevention, the measurement of the peripheral pulse (MPP) is currently the only guideline-recommended screening method among individuals aged 65 years or older. In contrast, MPP has never been applied in the setting of secondary stroke prevention, probably because several factors were expected to interfere with this simple technique, including sensomotor and neuropsychiologic handicaps of stroke patients 18. This study investigates feasibility and validity of MPP in this cohort (pilot phase) and compares daily MPP for 6 months with repeated holter-ECG in patients after ischemic stroke.
Behavioral: Measurement of peripheral pulse
Device: 72h holter ECG
|Study Design:||Observational Model: Cohort
Time Perspective: Prospective
|Official Title:||Know Your Pulse Post Stroke - Peripheral Pulse Taking to Detect Paroxysmal Atrial Fibrillation After Ischemic Stroke|
- Number of newly detected cases of atrial fibrillation [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- Comparison of detection rates by MPP and by serial holter ECG (3 months, 6 months) [ Time Frame: 6 months ] [ Designated as safety issue: No ]Rates of newly detected cases of atrial fibrillation using MPP are compared to the detection rate using holter ECG at 3 months and 6 months post inclusion
- Timepoint of detection of atrial fibrillation by MPP or holter ECG [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- Modification of secondary preventive medication by detection of atrial fibrillation [ Time Frame: 6 months ] [ Designated as safety issue: No ]
- Recurrent stroke and mortality [ Time Frame: 6 months ] [ Designated as safety issue: Yes ]
|Study Start Date:||May 2013|
|Estimated Study Completion Date:||October 2015|
|Estimated Primary Completion Date:||April 2015 (Final data collection date for primary outcome measure)|
Patients after ischemic stroke without a history of atrial fibrillation will perform measurements of peripheral pulse three times daily and in case of symptomatic arrhythmic episodes. Results will be entered into a diary which will be send to the center every month. In parallel to the measurements, patients will transmit ECGs via a mobile ECG recorder to the study center.
At 3 and 6 months after inclusion patients will be evaluated using 72h holter ECG. During the whole study period AEs as well as SAEs and changes in medications are recorded.
Behavioral: Measurement of peripheral pulse
All patients will be introduced and trained for the measurement of peripheral pulse. Patients will keep a pulse-diary tro detect atrial fibrillation.Device: 72h holter ECG
All petients will receive regular 72h Holter ECG at 3 and 6 months after inclusion in the study.
Other Name: Regular 72h Holter ECGs are used
Please refer to this study by its ClinicalTrials.gov identifier: NCT01858779
|Contact: Martin Köhrmann, MD||+49 9131 85 ext email@example.com|
|Contact: Bernd Kallmünzer, MD||+49 9131 85 ext firstname.lastname@example.org|
|Universitätsklinikum Erlangen; Dept. of Neurology||Recruiting|
|Erlangen, Bavaria, Germany, 91054|
|Contact: Martin Köhrmann, MD +49 9131 85 ext 39190 email@example.com|
|Contact: Bernd Kallmünzer, MD +49 9131 85 ext 39190 firstname.lastname@example.org|
|Principal Investigator: Martin Köhrmann, MD|
|Principal Investigator: Bernd Kallmünzer, MD|
|Sub-Investigator: Natalia Kurka, MD|
|Principal Investigator: Lars Marquardt, MD PHD|
|Sub-Investigator: Kosmas Macha, MD|
|Sub-Investigator: David Stark, MD|
|Study Chair:||Martin Köhrmann, MD||Universitätsklinikum Erlangen|
|Principal Investigator:||Bernd Kallmünzer, MD||Universitätsklinikum Erlangen|
|Principal Investigator:||Lars Marquardt, MD PHD||Universitätsklinikum Erlangen|