Cardiac complications frequently follow acute stroke. These complications include new-onset arrhythmias, which are also common in stroke patients who have not experienced heart disease before. For post-stroke patients, arrhythmias represent a key risk factor for complications and a worse prognosis. A recent study published in Nature / Scientific Reports aimed to detect the rate of atrial fibrillation (AF) and further cardiac arrhythmias after acute ischemic stroke. The authors used a 7-day Holter ECG which, according to these experts, had proved to be superior to standard 24-hour recordings [1].
The authors of the study stated that rhythm disturbances may also lead to brain ischemia. “AF represents a major cause of approximately 30% of strokes and, because of its possible paroxysmal pattern, it could be underdiagnosed.”
Claudia Carrarini et al. concluded that long-term cardiac monitoring is a well-recognized strategy for identifying individuals who ought to be submitted to further cardiological examinations. “For its technical characteristics (e.g., non-invasiveness and effectiveness) and its low costs, 7-day Holter ECG should be considered as a first-line approach.” Therefore, the authors continue, a 7-day Holter ECG should be carried out in the first hours after stroke and in all subjects with cryptogenic stroke in order to put in place timely therapeutical strategies.
Studies such as this demonstrate the superior value of 7-day ECGs compared to shorter periods of monitoring, outlines Dr. med. Ulrich Ingold. He works in the Cardiology and Internal Medicine Departments at Interlaken Hospital. Here, this procedure is being applied to patients who have suffered a stroke. The goal is to spot any risk of another stroke, which would be highly challenging to the patient. “In the canton of Berne, our standard is to use 7-day ECGs when we search for AF. If no AF is detected in the first 7-day phase, we do three in total – for example, with intervals of one or two months in between.”
In cases where AF is detected, therapy measures will be determined and carried out. Anti-coagulation is the path to take in these cases, but physicians need to make absolutely sure that the risk is present because this therapy comes with significant risks of its own. If AF is indeed identified during the 7-day ECG, this provides the necessary evidence for the therapy to be implemented.
“There is a second condition which calls for long-term ECGs beyond 3 days”, explains the cardiologist. “In cases when spontaneous arrythmias are reported by patients, only 7-day monitoring delivers the certainty to make an informed decision on which therapy to use.”
Today, 7-day ECGs are convenient, according to Dr. Ingold, as the patient sees the cardiology team in person to receive their Holter and to be provided with advice on how to apply it. The patient then carries the device themselves, and it records their heart rate on a chip. They return the Holter after seven days. Dr. Ingold explains, “We read the data from the chip and transmit it to the safe Cardiomatics cloud. Using artificial intelligence, our partner analyzes the data and sends us the results.” It is also important to mention that throughout Switzerland, care providers are reimbursed for 7-day ECG monitoring.
“We are highly satisfied with the Cardiomatics solution”, says Dr. Ingold. “It has provided top quality analyses.” Previously, in Interlaken and beyond, the evaluation of 7-day ECGs took an enormous effort. In particular, shortages of qualified staff made it difficult to do this manually, according to the cardiologist. “Today, our staff hand over the device to the patient and then, later, they get it back and transmit the data. This is all the staff time and resources that are invested in this. For patients too, the time taken is minimal.”
For the cardiology team at Interlaken and many other institutions, Cardiomatics has therefore solved a major issue. Rhythmologists have also been highly satisfied with the solution, underlines Dr. Ingold. “We were their first customers outside Poland, and our partners have proven to be extremely reliable. They work with University Hospital Basel too, which further adds to their credibility. We have communicated our satisfaction to other hospitals in Switzerland, which have also become faithful customers.”
7-day ECG monitoring provides major benefits and is low on resource use
Cardiac complications frequently follow acute stroke. These complications include new-onset arrhythmias, which are also common in stroke patients who have not experienced heart disease before. For post-stroke patients, arrhythmias represent a key risk factor for complications and a worse prognosis. A recent study published in Nature / Scientific Reports aimed to detect the rate of atrial fibrillation (AF) and further cardiac arrhythmias after acute ischemic stroke. The authors used a 7-day Holter ECG which, according to these experts, had proved to be superior to standard 24-hour recordings.
The authors of the study stated that rhythm disturbances may also lead to brain ischemia. “AF represents a major cause of approximately 30% of strokes and, because of its possible paroxysmal pattern, it could be underdiagnosed.”
Claudia Carrarini et al. concluded that long-term cardiac monitoring is a well-recognized strategy for identifying individuals who ought to be submitted to further cardiological examinations. “For its technical characteristics (e.g., non-invasiveness and effectiveness) and its low costs, 7-day Holter ECG should be considered as a first-line approach.” Therefore, the authors continue, a 7-day Holter ECG should be carried out in the first hours after stroke and in all subjects with cryptogenic stroke in order to put in place timely therapeutical strategies.
Studies such as this demonstrate the superior value of 7-day ECGs compared to shorter periods of monitoring, outlines Dr. med. Ulrich Ingold. He works in the Cardiology and Internal Medicine Departments at Interlaken Hospital. Here, this procedure is being applied to patients who have suffered a stroke. The goal is to spot any risk of another stroke, which would be highly challenging to the patient. “In the canton of Berne, our standard is to use 7-day ECGs when we search for AF. If no AF is detected in the first 7-day phase, we do three in total – for example, with intervals of one or two months in between.”
In cases where AF is detected, therapy measures will be determined and carried out. Anti-coagulation is the path to take in these cases, but physicians need to make absolutely sure that the risk is present because this therapy comes with significant risks of its own. If AF is indeed identified during the 7-day ECG, this provides the necessary evidence for the therapy to be implemented.
“There is a second condition which calls for long-term ECGs beyond 3 days”, explains the cardiologist. “In cases when spontaneous arrythmias are reported by patients, only 7-day monitoring delivers the certainty to make an informed decision on which therapy to use.”
Today, 7-day ECGs are convenient, according to Dr. Ingold, as the patient sees the cardiology team in person to receive their Holter and to be provided with advice on how to apply it. The patient then carries the device themselves, and it records their heart rate on a chip. They return the Holter after seven days. Dr. Ingold explains, “We read the data from the chip and transmit it to the safe Cardiomatics cloud. Using artificial intelligence, our partner analyzes the data and sends us the results.” It is also important to mention that throughout Switzerland, care providers are reimbursed for 7-day ECG monitoring.
“We are highly satisfied with the Cardiomatics solution”, says Dr. Ingold. “It has provided top quality analyses.” Previously, in Interlaken and beyond, the evaluation of 7-day ECGs took an enormous effort. In particular, shortages of qualified staff made it difficult to do this manually, according to the cardiologist. “Today, our staff hand over the device to the patient and then, later, they get it back and transmit the data. This is all the staff time and resources that are invested in this. For patients too, the time taken is minimal.”
For the cardiology team at Interlaken and many other institutions, Cardiomatics has therefore solved a major issue. Rhythmologists have also been highly satisfied with the solution, underlines Dr. Ingold. “We were their first customers outside Poland, and our partners have proven to be extremely reliable. They work with University Hospital Basel too, which further adds to their credibility. We have communicated our satisfaction to other hospitals in Switzerland, which have also become faithful customers.”
[1] https://www.nature.com/articles/s41598-021-04285-6.
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