Response to Letter Regarding Article, “High Prevalence of Atrial Fibrillation Among Patients With Ischemic Stroke”
Drs Haft and Teichholz present an excellent idea of how to prevent stroke with relatively easy means. However, we do not think this should be limited to patients who already had a stroke.
It is true that medical records and databases contain a lot of important information about patients. The problem is that valuable information is often buried among much else, which puts it out of reach for busy clinicians.
Automatic and recurrent scanning of computerized ECG databases and Holter archives for recordings showing atrial fibrillation is feasible, and it could help identify patients at risk of atrial fibrillation–related stroke, regardless of if there was a previous stroke or not. Such scanning could be made clinically useful if linkage can be established with the prescription database, whereby patients who already have anticoagulant treatment could be sorted out automatically, thus permitting physicians to concentrate on patients without proper treatment.
Studies are needed to assess the costs for such a program, as well as for the savings it will render in the form of fewer stroke victims to care for. Health economic calculations will differ according to local organization of the healthcare system, but considering the disastrous consequences of atrial fibrillation–related stroke and the huge costs for caring for stroke victims, we consider it likely that this proposition will result in savings wherever it is attempted.
Leif Friberg, MD
Department of Clinical Sciences Karolinska Institute
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- © 2014 American Heart Association, Inc.