Pacemaker-checks good way to ward off stroke

A new study has revealed that pacemakers identify atrial fibrillation and enable initiation of stroke prevention.

Atrial fibrillation (AF) is the most common heart rhythm disorder and affects 1.5-2 percent of people in the developed world, said Dr Denham, adding that AF increases the risk of stroke by five-fold. In addition, people who have strokes due to AF are more likely to die or be disabled as a result of their stroke.

He continued that the risk of stroke in patients with AF can be reduced by around two-thirds with medications that thin the blood, called anticoagulants, but around a third of patients with AF have no symptoms and do not know they have AF and are at increased stroke risk.

Pacemakers can detect asymptomatic AF but are not routinely monitored for this purpose. The current study investigated whether pacemaker checks could be used to identify patients with asymptomatic AF who could then be given anticoagulation for stroke prevention.

The average time between pacemaker checks and AF diagnosis was 6 months. Just over one-third of patients waited 12 months between checks to discover they had AF. Dr Denham said: "Stable patients have pacemaker checks every 12 months but our results support more frequent monitoring to identify AF. Otherwise patients are at increased stroke risk and are left unprotected."

Remote telemonitoring would allow pacemaker checks to be done more often without patients having to travel to hospital. Patients would require a computer that collects information from their pacemaker using wireless technology. The data would then be transmitted to a hospital computer.

He concluded: "One-third of people with AF don't know they have it so we need to use all of the tools available to recognise it. Our study suggests that pacemaker checks are a good way to identify new cases of AF so that anticoagulation can be started to prevent strokes."

The study was presented at Acute Cardiovascular Care 2015.