Abstract W P287: Collaborative Cryptogenic Stroke Clinic Improves Secondary Stroke Prevention While Helping Achieve Stroke Metrics
Introduction: Stroke centers are faced with the challenges of achieving stroke metrics to meet certification requirements. Recent trials have demonstrated the efficacy of the implantable cardiac monitor (ICM) in detecting atrial fibrillation (AF) in cryptogenic stroke patients. We have created a Comprehensive Cryptogenic Stroke Clinic (CCSC), a collaborative effort between electrophysiology (EP) and stroke neurology, which improves patient care and provides a venue for successfully addressing stroke metrics.
Methods: All acute ischemic stroke patients (n= 2100) in the ProMedica Stroke Network were screened and evaluated by an EP and vascular stroke neurologist. Appropriate cryptogenic patients are offered an ICM for AF detection, ideally during their stroke admission. Patients are evaluated periodically, both for their rhythm status and their stroke recovery, and important stroke metric follow-up data such as medication compliance, obtaining Modified Rankin scores at 90 days and prevention of stroke readmission through availability of resources.
Results: We have enrolled 135 patients in our CCS clinic and implanted 92 loop monitors for AF detection. Through follow-up in CCSC, we have: detected AF in 11 patients; identified 27 patients with additional therapy needs; and modified medical management for 38 patients to decrease their secondary stroke risk. 90-day Modified Rankin score compliance improved from 27% to 67%. The collaboration and efficiency has improved stroke outcomes and helped reduce readmission rates by 22% since the CCSC’s inception.
Conclusions: Our CCSC has improved compliance with multiple stroke metrics, while ensuring patients are cognizant of their real risk for another stroke. Our collaborative team approach has been instrumental in reducing stroke readmission rates, changing medical therapies, and offering additional resources are streamlined through medical collaboration. The CCSC has proven to be a critical venue for accomplishing successful stroke outcomes.
Author Disclosures: M. Richards: None. K. joseph: None. J. Auberle: None. S. Zaidi: None. M. Jumaa: None.
- © 2015 by American Heart Association, Inc.