Welcome!

News Feed Item

Northwestern Medicine Researchers Discover New Way to Prevent Some Strokes

Clinical trial links stroke and atrial fibrillation; findings will help better treat and prevent strokes for hundreds of thousands of people in the United States every year

CHICAGO, Feb. 17, 2014 /PRNewswire-USNewswire/ -- Larry Ambrose woke up one night, wandered into his kitchen but couldn't completely read the time on his microwave. A few days later when he noticed his blood pressure was unusually high, he went to the hospital and was diagnosed as having a stroke. Ambrose, like 25 percent of all stroke patients, experienced a cryptogenic stroke, meaning despite numerous tests, physicians were unable to determine a cause.

"There were no warning signs and I felt there was nothing I could do to stop it from happening again," said Ambrose, who is 75 years old. "It's a scary feeling."

For stroke patients like Ambrose, physicians believe atrial fibrillation, or a fast and irregular heartbeat, may occur without the patient's knowledge, causing the stroke. To better understand the connection between atrial fibrillation and stroke, Northwestern Medicine® physician researchers from cardiology and neurology teamed up to monitor people diagnosed with a cryptogenic strokes for intermittent atrial fibrillation using a tiny implantable cardiac monitor about the size of a jump drive. The patients monitored were part of a study called CRYSTAL AF (Study of Continuous Cardiac Monitoring to Assess Atrial Fibrillation after Cryptogenic Stroke). Northwestern Memorial Hospital was the leading enrolling site in North America for the four-year trial which enrolled 441 people across 55 centers. At Northwestern Memorial, 19 subjects enrolled in the trial, including Ambrose.

Approximately half were continuously monitored by the implanted cardiac monitor. The device monitored for the first documented event of atrial fibrillation following enrollment in the trial. Co-investigators  Richard Bernstein, MD, PhD director of the Northwestern Medicine Stroke Program and Telestroke, and Rod Passman, MD, medical director for the Center for Atrial Fibrillation at the Bluhm Cardiovascular Institute, are on the international steering committee for the CRYSTAL AF trial sponsored by Medtronic Cardiac Rhythm Disease Management.

The results – unveiled on Feb. 14 at the American Heart Association's International Stroke Conference in San Diego, Calif. – found that the device detected atrial fibrillation in 30 percent of people with cryptogenic stroke who were monitored. Using standard techniques, physicians only found atrial fibrillation in about 3 percent of these patients. Because of these results, the 30 percent patients were almost all switched to blood thinners which should protect them better from having another stroke, said Bernstein, who is also a professor of neurology at Northwestern University's Feinberg School of Medicine.

"Having a stroke really rattles your foundations," Bernstein said. "Being told by your doctor that they have no idea why you had it and that they are just guessing at the best medication to prevent another one is even worse. With this clinical trial, we eliminated that second problem-- not knowing the cause -- in about a third of those patients."

Because cryptogenic strokes are common, these findings could help hundreds of thousands of people every year. More than 750,000 people suffer a stroke in the United States every year and about one third of those are cryptogenic strokes.   

When atrial fibrillation is detected in a patient following stroke, anticoagulant therapy is recommended for secondary stroke prevention. While anticoagulant therapy can be successful in preventing future stroke, physicians do not use it proactively unless atrial fibrillation has been detected because of potential risk from the medication and complexity of the treatment.

The continuous monitoring device captured and automatically stored any abnormal ECG activity. Passman and his team then reviewed and analyzed the remotely-transmitted data. After the participants were implanted, they are followed at one month and every six months thereafter for three years. The control group received standard of care optimal medical treatment and followed up at the same intervals.

"We found using a tiny implantable device to detect an abnormal heart rhythm is much better than the usual tests we previously used," said Passman, who is also a professor of cardiology at the Feinberg School of Medicine "This is critical because finding a-fib in patients with stroke of unknown cause is important because once we find it, we put the patients on blood thinners and they are much more effective than the aspirin-like drugs they would otherwise take."

Ambrose was identified by Bernstein as a cryptogenic stroke patient and was the first subject implanted by Passman with the cardiac monitoring device at Northwestern Memorial. Each morning, he used a handheld Patient Assist Device to monitor if the implanted monitor has recorded any abnormalities. While atrial fibrillation was not detected in Ambrose, he said simply having the device was a comfort.

"I knew people were monitoring me and I was helping doctors figure out a way to end the worry of having a second stroke for other patients like me," said Ambrose, a Chicago resident. "Otherwise, I would have just gone home and been very nervous it was going to happen again."

To learn more about stroke services at Northwestern Memorial, visit our website or connect with us on social media.

About Northwestern Medicine®
Northwestern Medicine® is the collaboration between Northwestern Memorial HealthCare and Northwestern University Feinberg School of Medicine around a strategic vision to transform the future of healthcare.  It encompasses the research, teaching and patient care activities of the academic medical center. Sharing a commitment to superior quality, academic excellence and patient safety, the organizations within Northwestern Medicine comprise more than 9,000 clinical and administrative staff, 3,100 medical and science faculty and 700 students. The entities involved in Northwestern Medicine remain separate organizations. Northwestern Medicine is a trademark of Northwestern Memorial HealthCare and is used by Northwestern University.

About Northwestern Memorial Hospital
Northwestern Memorial is one of the country's premier academic medical center hospitals and is the primary teaching hospital of the Northwestern University Feinberg School of Medicine. Along with its Prentice Women's Hospital and Stone Institute of Psychiatry, the hospital has 1,705 affiliated physicians and 6,769 employees.  Northwestern Memorial is recognized for providing exemplary patient care and state-of-the art advancements in the areas of cardiovascular care; women's health; oncology; neurology and neurosurgery; solid organ and soft tissue transplants and orthopaedics.

Northwestern Memorial has nursing Magnet Status, the nation's highest recognition for patient care and nursing excellence. Northwestern Memorial ranks 6th in the nation in the U.S. News & World Report 2013-14 Honor Roll of America's Best Hospitals. The hospital is recognized in 14 of 16 clinical specialties rated by U.S. News and is No. 1 in Illinois and Chicago in U.S. News' 2013-14 state and metro rankings, respectively. For 14 years running, Northwestern Memorial has been rated among the "100 Best Companies for Working Mothers" guide by Working Mother magazine. The hospital is a recipient of the prestigious National Quality Health Care Award and has been chosen by Chicagoans as the Consumer Choice according to the National Research Corporation's annual survey for 15 consecutive years. 

SOURCE Northwestern Medicine

More Stories By PR Newswire

Copyright © 2007 PR Newswire. All rights reserved. Republication or redistribution of PRNewswire content is expressly prohibited without the prior written consent of PRNewswire. PRNewswire shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon.

Latest Stories
While DevOps most critically and famously fosters collaboration, communication, and integration through cultural change, culture is more of an output than an input. In order to actively drive cultural evolution, organizations must make substantial organizational and process changes, and adopt new technologies, to encourage a DevOps culture. Moderated by Andi Mann, panelists discussed how to balance these three pillars of DevOps, where to focus attention (and resources), where organizations might...
"When we talk about cloud without compromise what we're talking about is that when people think about 'I need the flexibility of the cloud' - it's the ability to create applications and run them in a cloud environment that's far more flexible,” explained Matthew Finnie, CTO of Interoute, in this SYS-CON.tv interview at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
The Internet giants are fully embracing AI. All the services they offer to their customers are aimed at drawing a map of the world with the data they get. The AIs from these companies are used to build disruptive approaches that cannot be used by established enterprises, which are threatened by these disruptions. However, most leaders underestimate the effect this will have on their businesses. In his session at 21st Cloud Expo, Rene Buest, Director Market Research & Technology Evangelism at Ara...
No hype cycles or predictions of zillions of things here. IoT is big. You get it. You know your business and have great ideas for a business transformation strategy. What comes next? Time to make it happen. In his session at @ThingsExpo, Jay Mason, Associate Partner at M&S Consulting, presented a step-by-step plan to develop your technology implementation strategy. He discussed the evaluation of communication standards and IoT messaging protocols, data analytics considerations, edge-to-cloud tec...
New competitors, disruptive technologies, and growing expectations are pushing every business to both adopt and deliver new digital services. This ‘Digital Transformation’ demands rapid delivery and continuous iteration of new competitive services via multiple channels, which in turn demands new service delivery techniques – including DevOps. In this power panel at @DevOpsSummit 20th Cloud Expo, moderated by DevOps Conference Co-Chair Andi Mann, panelists examined how DevOps helps to meet the de...
When growing capacity and power in the data center, the architectural trade-offs between server scale-up vs. scale-out continue to be debated. Both approaches are valid: scale-out adds multiple, smaller servers running in a distributed computing model, while scale-up adds fewer, more powerful servers that are capable of running larger workloads. It’s worth noting that there are additional, unique advantages that scale-up architectures offer. One big advantage is large memory and compute capacity...
In the world of DevOps there are ‘known good practices’ – aka ‘patterns’ – and ‘known bad practices’ – aka ‘anti-patterns.' Many of these patterns and anti-patterns have been developed from real world experience, especially by the early adopters of DevOps theory; but many are more feasible in theory than in practice, especially for more recent entrants to the DevOps scene. In this power panel at @DevOpsSummit at 18th Cloud Expo, moderated by DevOps Conference Chair Andi Mann, panelists discussed...
After more than five years of DevOps, definitions are evolving, boundaries are expanding, ‘unicorns’ are no longer rare, enterprises are on board, and pundits are moving on. Can we now look at an evolution of DevOps? Should we? Is the foundation of DevOps ‘done’, or is there still too much left to do? What is mature, and what is still missing? What does the next 5 years of DevOps look like? In this Power Panel at DevOps Summit, moderated by DevOps Summit Conference Chair Andi Mann, panelists loo...
"Loom is applying artificial intelligence and machine learning into the entire log analysis process, from start to finish and at the end you will get a human touch,” explained Sabo Taylor Diab, Vice President, Marketing at Loom Systems, in this SYS-CON.tv interview at 20th Cloud Expo, held June 6-8, 2017, at the Javits Center in New York City, NY.
A look across the tech landscape at the disruptive technologies that are increasing in prominence and speculate as to which will be most impactful for communications – namely, AI and Cloud Computing. In his session at 20th Cloud Expo, Curtis Peterson, VP of Operations at RingCentral, highlighted the current challenges of these transformative technologies and shared strategies for preparing your organization for these changes. This “view from the top” outlined the latest trends and developments i...
With major technology companies and startups seriously embracing Cloud strategies, now is the perfect time to attend 21st Cloud Expo October 31 - November 2, 2017, at the Santa Clara Convention Center, CA, and June 12-14, 2018, at the Javits Center in New York City, NY, and learn what is going on, contribute to the discussions, and ensure that your enterprise is on the right path to Digital Transformation.
@DevOpsSummit at Cloud Expo taking place Oct 31 - Nov 2, 2017, at the Santa Clara Convention Center, Santa Clara, CA, is co-located with the 21st International Cloud Expo and will feature technical sessions from a rock star conference faculty and the leading industry players in the world. The widespread success of cloud computing is driving the DevOps revolution in enterprise IT. Now as never before, development teams must communicate and collaborate in a dynamic, 24/7/365 environment. There is ...
The financial services market is one of the most data-driven industries in the world, yet it’s bogged down by legacy CPU technologies that simply can’t keep up with the task of querying and visualizing billions of records. In his session at 20th Cloud Expo, Karthik Lalithraj, a Principal Solutions Architect at Kinetica, discussed how the advent of advanced in-database analytics on the GPU makes it possible to run sophisticated data science workloads on the same database that is housing the rich...
What's the role of an IT self-service portal when you get to continuous delivery and Infrastructure as Code? This general session showed how to create the continuous delivery culture and eight accelerators for leading the change. Don Demcsak is a DevOps and Cloud Native Modernization Principal for Dell EMC based out of New Jersey. He is a former, long time, Microsoft Most Valuable Professional, specializing in building and architecting Application Delivery Pipelines for hybrid legacy, and cloud ...
Amazon started as an online bookseller 20 years ago. Since then, it has evolved into a technology juggernaut that has disrupted multiple markets and industries and touches many aspects of our lives. It is a relentless technology and business model innovator driving disruption throughout numerous ecosystems. Amazon’s AWS revenues alone are approaching $16B a year making it one of the largest IT companies in the world. With dominant offerings in Cloud, IoT, eCommerce, Big Data, AI, Digital Assista...