Stroke can strike at any moment, and once a person has a stroke they are at markedly increased risk for a second event.
A complete and thorough workup all too often yields little or no insight as to the cause of these potentially devastating and debilitating events. Neurologists call these strokes “cryptogenic,” meaning the cause of the stroke is not known. Now an innovative procedure, offered through the ProMedica Toledo Hospital cryptogenic stroke clinic, gives patients and their families hope for determining the cause of some cryptogenic strokes. The implantable loop recorder monitors patients’ heart rhythms and is a prime example of using technology for secondary stroke prevention.
Kevin Williams of Sylvania was one of the first cryptogenic stroke patients to receive the loop recorder. The technology is now much smaller than a flash drive, and is essentially injected under the skin. It continuously monitors patients’ hearts for an abnormal rhythm called atrial fibrillation (AF), which may increase the risk of stroke in certain patients. The rhythm information is relayed wirelessly in less than 24 hours to ProMedica stroke experts, who then make decisions about initiating blood thinners to reduce the risk of a second, more serious stroke.
“I had the loop recorder implanted following my stroke in September 2013,” Kevin said. “In February, my wife and I — and the stroke team at ProMedica — all noticed immediately that I was having a cardiac event one Sunday afternoon. Luckily, my heart rate just increased when I became excited during a hunting trip.”
Not wanting to take any chances with his health, the device adds a little comfort and assurance to Kevin’s daily routine.
“It gives me peace of mind to know what is happening and that I am being monitored on an ongoing basis,” he said.
According to Kelley Joseph, RN, stroke care coordinator for ProMedica Stroke Network and cryptogenic stroke clinic manager, more than 120 of these devices have been implanted in stroke patients at ProMedica. Heart rhythm data is downloaded daily and monitored and interpreted for AF.
“25 patients at ProMedica have been found to have AF. Like Kevin Williams, we changed their medical management from antiplatelet therapy to anticoagulation and that will greatly reduce the risk of future strokes that would have been undiagnosed and untreated,” Joseph said.
Mark Richards, MD, FACC, FHRS, ProMedica Physicians electrophysiologist and medical director of the cryptogenic stroke clinic, added, “Cryptogenic strokes account for up to 35 percent of stroke cases and often affect adults 45 or younger like Kevin. The diagnosis and ongoing, long-term monitoring and treatment by physicians, healthcare providers and patients themselves are critical to preventing future strokes.”
Recognized by The Joint Commission as a certified Primary Stroke Center, the cryptogenic stroke clinic at Toledo Hospital is paving the way for other hospitals. ProMedica’s innovative approach to treating and monitoring this population of patients with a high propensity for atrial fibrillation is being shared with healthcare systems across the country.
Risk factors of stroke include high blood pressure, smoking, diabetes and high cholesterol. Other significant causes are AF, carotid artery stenosis, which causes clot forming, and a narrowing of the vessels, and states that render the blood more likely to clot.
To learn more, please visit www.promedica.org/neurology.