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Avoid strokes by better diagnosis of cardiac arrhythmias
Cardiac arrhythmias in the form of atrial fibrillation are considered to be a significant risk factor for the development of a stroke. A reliable early detection of corresponding cardiac arrhythmias could therefore also use the prevention of strokes. For this purpose, scientists of the University Medical Center Göttingen (UMG) together with colleagues from Mainz have developed a new method for a better diagnosis of atrial fibrillation.
The new simple, inexpensive and harmless "diagnostic concept detects cardiac arrhythmia in stroke patients better than currently used procedures," said the University of Göttingen. With his help, the atrial fibrillation can be detected early and significantly reduce the risk of stroke, the researchers report. The scientists presented their new diagnostic concept in the renowned journal "Lancet Neurology".
Better detection of atrial fibrillation prevented many strokes. (Photo: Sonja Calovini / fotolia.com Atrial fibrillation most common cause of a stroke
According to the doctors, atrial fibrillation is "one of the most common causes of strokes." It is practically considered a harbinger of stroke, which in turn often leads to life-long restrictions and disabilities for those affected. The cause of the association between atrial fibrillation and strokes is the formation of blood clots in the heart during atrial fibrillation. These clots can be transported in the direction of the brain, where they clog the vessels and thus lead to a stroke. In Germany, according to the UMG, around 280,000 people suffer a stroke every year, with a lack of blood supply to the brain usually being the cause (ischemic stroke). "As a result of the stroke, there is often a life-long restriction in everyday life, many patients are permanently in need of care," said the UMG.
Nearly 400 stroke patients were examined
In their investigations, the scientists went to Professor Rolf Wachter of the Department of Cardiology and Pulmonology of UMG and Privatdozent Dr. med. Klaus Gröschel from the Department of Neurology at the University Medical Center Mainz asked to what extent stroke patients could benefit from an improved examination of cardiac arrhythmias. For this purpose, a total of 398 patients with fresh stroke were examined.
Long-term ECG with significantly better results
The researchers provided part of the subjects with a "long-term ECG over ten days, which was performed a total of three times and evaluated in a specialized laboratory," reports the UMG. The other patients received the current standard diagnostics. The results speak for themselves according to the researchers. For example, cardiac arrhythmias in the form of atrial fibrillation were detected three times more frequently in the group with long-term ECG diagnostics (13.5 percent) than in the group with standard diagnostics (4.5 percent)..
Atrial fibrillation is often overlooked
According to Professor Wachter, atrial fibrillation is often not recognized because the arrhythmia only occurs for a few minutes. Therefore, the symptoms are easily overlooked in the current cardiovascular tests. "However, if atrial fibrillation is detected in time, a stroke can be prevented as a result," says Prof. Wachter. According to the expert, better detection of atrial fibrillation is probably "the most promising strategy to reduce the number of strokes."
Possibilities of drug prevention
According to Dr. Klaus Gröschel was already known from preliminary examinations that an extended long-term ECG can detect atrial fibrillation in every eighth stroke patient. This finding is important, as drugs are available that can reduce the risk of a new stroke in the affected patients by about 70 percent, explains the neurologist Dr. med. Gröschel.
New procedure has been proven to prevent strokes
So far, according to the researchers, there was no evidence that their procedure actually found cases of atrial fibrillation that would normally not be detected. "That's why we did a study that randomly gave patients either our extended long-term ECG or standard procedures that only took one to three days to record rhythm," Dr. Mark Weber-Krüger, coordinator of the study at the UMG. Only then can one prove whether the new procedure is better. The result was quite convincing.
Important step on the way to personalized medicine
The data on repeated strokes in the long-term ECG group were also positive. Here, patients developed about 40 percent fewer new strokes and stroke precursors (transient ischemic attacks), the researchers report. Now another larger study with 5,000 participants is planned to review the current results. "We want to show that we not only find more atrial fibrillation, but also prevent strokes," emphasizes Prof. Wachter. With the current study, an important step towards personalized medicine has already been achieved, and improved diagnostics can be used to assign patients exactly the therapies they need. (Fp)