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Patient-reported feasibility of chest and thumb ECG after cryptogenic stroke in Sweden: an observational study.

ABSTRACT: OBJECTIVES:The aim of this study was to assess the feasibility, based on a questionnaire, of the chest and thumb ECG system Coala Heart Monitor in patients who recently had a stroke. DESIGN:Observational study. SETTING:Two stroke units, Region Gävleborg, Sweden. PARTICIPANTS AND INTERVENTIONS:This study, Transient ECG Assessment in Stroke Evaluation (TEASE), included patients who had a stroke between 2017 and 2019. Patients eligible for anticoagulation in the presence of atrial fibrillation were scheduled for 28 days monitoring. PRIMARY AND SECONDARY OUTCOME MEASURES:The questionnaire regarding feasibility of monitoring included seven questions, using a 100?mm Visual Analogue Scale which covered overall satisfaction, technical feasibility, remember to monitor, physical application, feeling of security, help from others and recommendation to others. A lower score indicated better outcome. RESULTS:The prespecified number of 100 patients underwent the monitoring and 83 out of the 97 alive patients returned the questionnaire (response rate 85.6%). The median age was 69.5 years, mean CHA2DS2-VASc score was 4.4±1.3 points and 59.0% were men (n=49). The median time from index stroke to start of monitoring was 7.0 days. Patients performed on average 90.1%±15.0% of scheduled ECG-transmissions. In all seven questions, the median score ranged from 4 to 8. The vast majority reported acceptable outcomes, that is, the 95th percentile ranged from 30 to 54. There was no significant difference between men and women with regard to any of the seven questions (p values ranging from 0.117 to 0.849). Two of the seven outcome scores correlated significantly to patient age (Spearman's r=-0.238 and r=-0.308, and p values 0.031 and 0.005 for 'overall satisfaction' and 'remember to monitor', respectively). CONCLUSION:In stroke survivors, chest and thumb ECG two times per day over a period of 4?weeks is feasible from a patient's perspective. The Coala Heart Monitor provides a valuable and convenient tool for monitoring after stroke. TRIAL REGISTRATION NUMBER:NCT03301662.

SUBMITTER: Magnusson P

PROVIDER: S-EPMC7594353 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Patient-reported feasibility of chest and thumb ECG after cryptogenic stroke in Sweden: an observational study.

Magnusson Peter P Lyren Adam A Mattsson Gustav G

BMJ open 20201028 10

<h4>Objectives</h4>The aim of this study was to assess the feasibility, based on a questionnaire, of the chest and thumb ECG system Coala Heart Monitor in patients who recently had a stroke.<h4>Design</h4>Observational study.<h4>Setting</h4>Two stroke units, Region Gävleborg, Sweden.<h4>Participants and interventions</h4>This study, Transient ECG Assessment in Stroke Evaluation (TEASE), included patients who had a stroke between 2017 and 2019. Patients eligible for anticoagulation in the presenc ...[more]

PMID: 33115891

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Project description:INTRODUCTION:Atrial fibrillation (AF) causes ischaemic stroke and based on risk factor evaluation warrants anticoagulation therapy. In stroke survivors, AF is typically detected with short-term ECG monitoring in the stroke unit. Prolonged continuous ECG monitoring requires substantial resources while insertable cardiac monitors are invasive and costly. Chest and thumb ECG could provide an alternative for AF detection poststroke.The primary objective of our study is to assess the incidence of newly diagnosed AF during 28 days of chest and thumb ECG monitoring in cryptogenic stroke. Secondary objectives are to assess health-related quality of life (HRQoL) using short-form health survey (SF-36) and the feasibility of the Coala Heart Monitor in patients who had a stroke. METHODS:Stroke survivors in Region Gävleborg, Sweden, will be eligible for the study from October 2017. Patients with a history of ischaemic stroke without documented AF before or during ECG evaluation in the stroke unit will be evaluated by the chest and thumb ECG system Coala Heart Monitor. The monitoring system is connected to a smartphone application which allows for remote monitoring and prompt advice on clinical management. Over a period of 28 days, patients will be monitored two times a day and may activate the ECG recording at symptoms. On completion, the system is returned by mail. This system offers a possibility to evaluate the presence of AF poststroke, but the feasibility of this system in patients who recently suffered from a stroke is unknown. In addition, HRQoL using SF-36 in comparison to Swedish population norms will be assessed. The feasibility of the Coala Heart Monitor will be assessed by a self-developed questionnaire. ETHICS AND DISSEMINATION:The study was approved by The Regional Ethical Committee in Uppsala (2017/321). The database will be closed after the last follow-up, followed by statistical analyses, interpretation of results and dissemination to a scientific journal. TRIAL REGISTRATION NUMBER:NCT03301662; Pre-results.

Dataset Information

Patient-reported feasibility of chest and thumb ECG after cryptogenic stroke in Sweden: an observational study.

Publications

Patient-reported feasibility of chest and thumb ECG after cryptogenic stroke in Sweden: an observational study.

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