A joint project involving NHS Highland, the University of the Highlands and Islands, and Daiichi Sankyo has been recognised at this year’s Global AF Association Healthcare Pioneers Awards at Westminster Palace, London.
Led by Professor Steve Leslie, Consultant Cardiologist with NHS Highland (NHSH), with support from Dr Adam Giangreco (UHI) and Ms Karen Thomas (Daiichi Sankyo), the project looked at using new technology to help detect the heart rhythm problem atrial fibrillation (AF) in stroke and transient ischemic attack (TIA) patients.
AF is a major cause of recurrent stroke and TIA in the UK, with many patients exhibiting intermittent, often asymptomatic paroxysmal AF (pAF). Each year NHS Highland sees more than 600 patients with stroke or TIA, 68% of whom have no persistent AF detected at time of diagnosis.
This evaluation assessed the clinical and health economic benefits of pAF monitoring using R-TEST single lead ECG devices. Patients not in persistent AF were identified by a member of the stroke team and referred for a device either as an inpatient or outpatient.
In the 100 patients who were referred for an R-TEST device, pAF was detected in 8.4% who had had a stroke and 5.9% with a TIA. Similarly, 9.3% of inpatients and 6.5% of outpatients were identified with pAF. All patients diagnosed with pAF were provided appropriate anticoagulation therapy.
The incidence of pAF in this evaluation (5.9–8.4%) was used to estimate which patients with undiagnosed and untreated AF were predicted to be at high risk of secondary stroke within one year of their initial stroke or TIA. Implementing R-TEST monitoring and anticoagulation is predicted to prevent a number of these secondary strokes.
Professor Steve Leslie said: “Through this evaluation we were able to demonstrate that establishing post-stroke AF monitoring improves patient care, reduces remote and rural health inequalities and, as it can happen within existing NHS resources, is ultimately a cost saving.
“This was a great project to be involved with and it has shown some excellent results. It’s been good to see it be highly commended at the awards and shows how well collaboration across sectors can work. I’m delighted for the team that it has been recognised.”
This project, which was supported with funding from the Inverness and Highland City Region Deal, was a collaboration including staff in cardiology (Mrs Kara Callum, Mrs Lynsey Macpherson, Mr Nick Howard, Mrs Claudia Graune, Prof Steve Leslie), the stroke unit (Mrs Susan Gallacher, Mrs Linda Campbell, Dr Gethin Williams, Dr Ashish Macaden), UHI (Prof Ian Megson, Dr Adam Giangreco) and Napier University (Dr David Muggeridge).