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Current Practices of Cardiac Monitoring and Early Rhythm-Control Therapy for Atrial Fibrillation and Stroke Prevention

Published online by Cambridge University Press:  24 April 2025

Vignan Yogendrakumar Open the ORCID record for Vignan Yogendrakumar [Opens in a new window] ,
Diana Ayan ,
Thalia S. Field Open the ORCID record for Thalia S. Field [Opens in a new window] ,
Jason G. Andrade ,
Gustavo Saposnik ,
Michael D. Hill Open the ORCID record for Michael D. Hill [Opens in a new window]  and
Luciano A. Sposato
Vignan Yogendrakumar*
Affiliation:
Division of Neurology, The Ottawa Hospital and Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
Diana Ayan
Affiliation:
Heart and Brain Laboratory, Western University, London, Canada
Thalia S. Field
Affiliation:
Vancouver Stroke Program, University of British Columbia, Vancouver, Canada
Jason G. Andrade
Affiliation:
Centre for Cardiovascular Innovation and Division of Cardiology, University of British Columbia, Vancouver, Canada
Gustavo Saposnik
Affiliation:
Stroke Outcomes and Decision Neuroscience Research Unit, Department of Medicine, St. Michael’s Hospital-Unity Health, University of Toronto, Toronto, Canada
Michael D. Hill
Affiliation:
Department of Clinical Neurosciences, University of Calgary, Calgary, Canada
Luciano A. Sposato
Affiliation:
Heart and Brain Laboratory, Western University, London, Canada Departments of Clinical Neurological Sciences, Epidemiology and Biostatistics and Anatomy and Cell Biology, Schulich School of Medicine and Dentistry, Western University, London, Canada
*
Corresponding author: Vignan Yogendrakumar; Email: viyogendrakumar@toh.ca
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Abstract

We conducted an international survey of stroke physicians to assess practices and attitudes toward cardiac monitoring and early rhythm control. A 20-question survey was completed by 241 clinicians representing 61 countries. The minimum duration of actionable atrial fibrillation varied widely, and more than 90% (223/241) of respondents indicated a willingness to enroll patients in a trial assessing the ideal duration of cardiac monitoring. Only a quarter of respondents (62/241) offered early rhythm control for patients with atrial fibrillation, with the majority (209/241, 87%) expressing an opinion that there was equipoise about the benefit of rhythm control in the post-stroke population.

Résumé

RÉSUMÉ

Pratiques courantes en matière de surveillance cardiaque et de traitement précoce de la fibrillation auriculaire en vue de la prévention des accidents vasculaires cérébraux.

L’équipe de recherche a mené une enquête internationale chez des médecins expérimentés dans le traitement des accidents vasculaires cérébraux (AVC) sur les pratiques en matière de surveillance cardiaque et de régularisation précoce du rythme cardiaque, ainsi que sur leur attitude à l’égard du sujet. Au total, 241 médecins cliniciens représentant 61 pays ont rempli le formulaire, qui comptait 20 questions. La durée minimale de fibrillation auriculaire (FA) nécessitant la mise en œuvre d’un traitement est très variable, et plus de 90 % des répondants (223/241) se sont montrés disposés à recruter des patients prêts à participer à un essai clinique visant à évaluer la durée idéale de la surveillance cardiaque. Un quart seulement des répondants (62/241) proposait un traitement précoce de l’arythmie aux patients atteints de FA, tandis que le reste (209/241; 87%) a fait part d’une incertitude absolue quant aux avantages de la régularisation du rythme cardiaque chez les personnes ayant déjà subi un AVC.

Keywords

Cardiologystrokestroke prevention
Type
Brief Communication
Information
Canadian Journal of Neurological Sciences , First View , pp. 1 - 3
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of Canadian Neurological Sciences Federation

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References

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