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Occasional erratic heart rhythms appear to cause about one-fifth of strokes for which a cause is not readily established, according toresearch presented at the American Stroke Association'sInternational Stroke Conference 2012. About one-third of survivors leave the hospital with the cause oftheir stroke still undetermined. "Identifying and treating these patients for irregular rhythm couldreduce the recurrence of stroke by 40 percent compared to reducingthe risk by treating them with aspirin," said Daniel J. Miller,M.D., the study's first author and a senior staff neurologist atHenry Ford Hospital in Detroit, Mich. "The cause doesn't make adifference if there isn't a treatment, and recently two newmedications - dabigatran and rivaroxaban - have been approved bythe FDA to treat this problem." The study confirmed a 2008 report that found 13 of 56 patients (23percent) whose heart rhythms were measured by automated monitorsfor 21 days had intermittent, or paroxysmal atrial fibrillation (PAF). Such episodes can last for a few seconds up to severaldays. The 2008 study suggested that erratic beats of less than 30 secondsmight indicate more prolonged episodes of PAF that lead to smallblood clot formation in the hearts of patients with otherwiseunidentified causes for their strokes. Since the study, strokespecialists have debated the importance of PAF to patients. Some stroke centers, including Henry Ford Hospital, adopted theMobile Cardiac Outpatient Monitoring™ (MCOT™) system asa method of identifying PAF. Miller and his colleagues examined the medical records of 156patients (half women) who had undergone monitoring no more than sixmonths after a stroke or transient ischemic attack (TIA), most of them for 21 days. Ninety-seven percent were nottaking prescription anticoagulation drugs. Of the total, 27 patients (17.3 percent) had one or more PAFepisodes during monitoring and the number increased significantlyover time. In the first two days, 3.9 percent of the patientsexperienced an episode of PAF. The percentage rose to 9.2 percentafter one week, 15.1 percent at two weeks and 19.5 percent by threeweeks, after accounting for those that had stopped monitoringearly. Patients identified at study entry with premature atrialcontractions - the most common type of erratic heartbeats - were13.7 times more likely to have PAF than those without the rhythmproblems. "That's a very high risk," Miller said. Excluding TIA patients, the presence of premature atrialcontractions in stroke survivors increased their risk of PAF to 17times. Each one level increase in a patient's National Institutesof Health Stroke Scale increased the risk of AF by 20 percent. The42 point scale provides physicians a standardized method to assessa patient's stroke-induced impairment. The other risk factors applicable to stroke and TIA patients were: Being female. Women in the study had 6.2 times a man's risk of PAF.In stroke patients alone, the risk was 4.6 times. Having a left atrium enlarged by 1 centimeter in diameter. Thisfinding increased the AF risk 2.3 times. A reduction in blood pumped by the heart. People whose leftventricle expelled 10 percent less blood than a healthy heart had a1.8 times risk. "Patients with stroke of unknown origin should have at least 21days of MCOT monitoring to reliably detect paroxysmal atrialfibrillation in order to reduce their risk of future stroke,"Miller said. Additional References Citations. The e-commerce company in China offers quality products such as Neck Strap Lanyard , PET Lanyard, and more. For more , please visit Polyester Lanyard today!
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