Approximately 30 percent of ischemic strokes are cryptogenic, which are strokes for which doctors cannot determine a definitive cause. These strokes may be caused by atrial fibrillation (AF), which is a disorder of the heart where the top two chambers of the heart quiver rather than beat regularly. This causes blood to pool in the chambers, forming clots, which can cause strokes.
Cone Health has a highly specialized team that coordinates a state-of-the-art program to identify and treat cryptogenic stroke patients quickly and effectively, and has recently released new research with the goal of identifying AF and preventing subsequent strokes for cryptogenic stroke patients.
The team developed a new protocol for evaluation of patients with cryptogenic stroke using an implantable loop recorder (ILR) for detection of AF. Patients implanted with ILR have a transmitter in their house that monitors for AF. The battery can last for up to three years. If AF occurs, Cone Health is notified, in which case they can bring the patient in to begin them on blood thinners or other medicines to help prevent another stroke from occurring.
Stroke patients have historically been monitored for AF for about a month after a stroke using an external event monitor, as opposed to the 3 years of monitoring that the IRL offers. Research has shown that long-term monitoring of stroke patients can find many at risk of AF and future strokes, with the global average for AF occurring after 84 days. With the earlier technology, AF would have been missed by doctors since it often occurred after the 30-day monitoring window, and the individual may have suffered a subsequent stroke. Strokes in patients with AF tend to be more disabling and fatal than those in patients without AF. If you have had a stroke before and doctors did not find a cause, talk to your doctor to see if you could be a candidate for ILR.
Dr. James Allred is a cardiologist and the director of the Cone Health Atrial Fibrillation Center. Dr. Allred is a 2002 graduate of Medical College of Virginia, completing a residency in internal medicine at Duke University Medical Center. He is a leading expert in electrophysiology and treating arrhythmia, completing a fellowship in cardiovascular disease and electrophysiology at University Alabama-Birmingham.
Sharon Biby is a nurse practitioner and coordinator of Cone Health Stroke Center. She received her Bachelor of Science in nursing and Masters of Science in nursing and gerontological nurse practitioner from University of North Carolina at Greensboro. She earned a postgraduate certificate as an adult nurse practitioner from UNCG in 2000, and a postgraduate certificate as an acute neurovascular advanced practitioner from Arizona State University and University of Alabama-Birmingham in 2011.