Post-Stroke rapid assessment of Cardiac arrhythmia evaluation
Research type
Research Study
Full title
Post-Stroke rapid assessment of Cardiac arrhythmia evaluation- The Pace Study
IRAS ID
286020
Contact name
Gemma Whitehead
Contact email
Sponsor organisation
Newcastle Hospitals NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Paroxysmal atrial fibrillation (PAF) is a type of irregular heart rhythm that is a known risk factor for stroke. It is thought that 20% of ischaemic strokes are due to this. It can be treated with blood thinning medication; however, there is no standard cost effective strategy for detecting PAF in post stroke patients.
Clinicians will arrange for patients with suspected PAF to be fitted with a non-invasive heart monitor that will record rhythms for a short period a few weeks after discharge.
NICE guidelines recommend at least 24 hours of monitoring at this stage but research suggests that this will identify PAF in only 4.6% of patients.
It has been widely shown that to a certain point, the longer the monitoring period, the higher the chance of PAF detection.
We propose to use a new approved monitor which will produce an automatic report instantly once removed indicating whether PAF has been detected. We suspect that longer and more rapid post stroke monitoring will detect PAF in more patients.
This device can remain on the patient for up to 7 days or day of discharge (which is likely to come sooner) thus eliminating the need for patients to come in a further two or three times as an outpatient.
Patients will be randomised to the new pathway or the standard care pathway with a 50% chance of receiving either.
At the end of the study, in both groups we will compare:
Number of patients with PAF detected
Number of patients being commenced on long term medication as a result of detected PAF
Secondary outcomes:
We will study the number of hospital visits required in both arms, workload for both clinical and administrative staff, and projected number of strokes prevented based upon the additional number of patients receiving long term anticoagulation following PAF detection.REC name
North East - Newcastle & North Tyneside 2 Research Ethics Committee
REC reference
20/NE/0264
Date of REC Opinion
10 Feb 2021
REC opinion
Further Information Favourable Opinion