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Post-Cryptogenic Stroke Pathway

Early detection of post-stroke AF with comprehensive monitoring program

AF patients are at 5x greater risk for stroke1

Detect silent atrial fibrillation (AF) in your cryptogenic stroke patients quicker to lower the risk of a second stroke by using MCOT® (Mobile Cardiac Outpatient Telemetry) technology through our comprehensive monitoring program that provides a simple, noninvasive, outpatient solution that will elevate the standard of care you can offer your patients and streamline the workflow for the practice.

Benefits
Lower cost of care2
Capture AF more quickly1
Reduce risk of second stroke2

100 %

Proven to detect AF with 100% sensitivity and 100% positive predictivity in the detection of
≥30-second AF episodes. 3

5x better

Proven to be more than five times better at diagnosing post-stroke AF than the ILR after 21 days of monitoring1

8x lower

Almost 8 times lower costs were achieved with improved detection rates and reduction of secondary stroke risk due to new anticoagulant use in subjects with MCOT patch detected AF.2
Philips BioTel Heart comprehensive monitoring program enables your organization to meet the AHA/ASA Guidelines which suggest that for patients who have had an acute ischemic stroke or TIA with no other apparent cause, prolonged AF monitoring (~30 days) is reasonable within 6 months of the event.4

Philips BioTel Heart Post-Crypotgenic Stroke Pathway

Detection of AF in post-cryptogenic stroke patient with a diagnosis of Cerebral Infarction, unspecified.

Female, 65 years old
Diagnosis: Cerebral Infarction, unspecified

Findings: Urgent - New onset atrial fibrillation/flutte

HR: 80

Automatic recording/
no symptoms

Comments: Verbal Notification

ORIGINAL RESEARCH

Mobile Cardiac Outpatient Telemetry patch vs Implantable Loop Recorder in cryptogenic stroke patients in the US – cost-minimization model

Authors
Goran Medic,¹,² Nikos Kotsopoulos,³ Mark P Connolly,²,³ Jennifer Lavelle,⁴ Vincent Norlock,⁴ Manish Wadhwa,⁴ Belinda A Mohr,⁵ Wayne M Derkac⁴

¹Chief Medical Office, Philips Healthcare, Eindhoven, Netherlands; ²Department of Pharmacy, University of Groningen, Groningen, ³ Netherlands; Global Market Access Solutions LLC, Charlotte, NC, USA; ⁴BioTelemetry, Inc., A Philips Company, Malvern, PA, USA; ⁵Chief Medical Office, Philips, Cambridge, MA, USA
Source
Med Devices (Auckl). 2021;14:445-458 https://doi.org/10.2147/MDER.S337142
Study Results
MCOT

Atrial fibrillation detected by Mobile Cardiac Outpatient Telemetry (MCOT) in cryptogenic TIA or stroke

Authors
A.H Tayal, MD; M. Tian, RN; K.M Kelly, MD, PhD; S.C. Jones, PhD; D.G.Wright, MD; D. Singh, MD; J. Jarouse, CRNP; J. Brillman, MD; S. Murali, MD; R. Gupta, MD
Source
Neurology®
Volume 71, Number 21, November 2008
Study Results
From the *Department of Neurology, Mayo Clinic, Rochester, MN; †Department of biomedical Statistics, May Clinic, Rochester, MN; ‡Department of Neurology, Boston University, Boston, MA, §Department of Neurology, National University of Singapore, Singapore, Singapore; ||Department of Neurology, Cleveland Clinic, Cleveland, OH; ¶Department of Radiology, Mayo Clinic, Rochester, MN
ATRIAL FIBRILLATION IN CRYPTOGENIC STROKE

Outpatient cardiac telemetry detects a high rate of atrial fibrillation in cryptogenic stroke

Authors
Daniel J. Milleraa, Muhib A. Khana, Lonni R. Schultza, Jennifer R. Simpsonb, Angelos M. Katramadosa, Andrew N. Russmana, Panayiotis D. Mitsiasa
aHenry Ford Hospital, Detroit, MI, United States, bUniversity of Colorado, Denver, CO, United States
Source
Journal of the Neurological Sciences 324 (2013), p. 57-61 https://www.ahajournals.org/ doi/10.1161/str.43.suppl_1.A150
Study Results
UNIVERSITY OF PENNSYLVANIA STUDY

Predictors of finding occult atrial fibrillation after cryptogenic stroke

Authors
Christopher G. Favilla, MD*; Erin Ingala, MD*; Jenny Jara, BA; Emily Fessler, BA; Brett Cucchiara, MD; Steven R. Messé, MD; Michael T. Mullen, MD; Allyson Prasad, CRNP; James Siegler, MD; Mathew D. Hutchinson, MD; Scott E. Kasner, MD. From the Department of Neurology and Division of Cardiology at University of Pennsylvania .
*Drs. Favilla and Ingala contibuted equally
Source
stroke. 2015;46:1210-1215. DOI:10.1161/STROKEAHA.114.007763. https://www.ahajournals.org/ doi/10.1161/STROKEAHA.114.007763
Study Results
CASE-CONTROL STUDY

Paroxysmal atrial fibrillation in cryptogenic stroke

Authors
Alejandro A. Rabenstein, MD,* Jennifer E. Fugate, DO,* Jay Mandrekar, PhD,† Joseph D. Burns, MD,*‡ Raymond C.S. Seet, MD,*§ Stefan A. Dupont, MD,* || Timothy J. Kauffman, MD,¶ Samuel J. Asirvatham, MD,** and Paul A. Friedman, MD**

From the *Department of Neurology, Mayo Clinic, Rochester, MN; †Department of biomedical Statistics, May Clinic, Rochester, MN; ‡Department of Neurology, Boston University, Boston, MA, §Department of Neurology, National University of Singapore, Singapore, Singapore; ||Department of Neurology, Cleveland Clinic, Cleveland, OH; ¶Department of Radiology, Mayo Clinic, Rochester, MN
Source
Journal of Stroke and Cerebrovascular Diseases, 2013
Study Results

Frequently Asked Questions

For Patients

Multiple studies have demonstrated that asymptomatic atrial fibrillation commonly occurs in patients following cryptogenic stroke. ECG monitoring plays an important role in the follow-up, as it can help your physician identify if you are at higher risk of a second stroke or requiring antiarrhythmic drug (AAD) therapy.

An estimated 3 million Americans suffer from Atrial Fibrillation (AFib). AFib is an irregular heartbeat, usually fast, caused when the top chambers of the heart quiver erratically. AFib can have a significant negative impact on your quality of life, causing heart palpitations, chronic fatigue, and debilitating pain. Untreated AFib also increases the risk of stroke five-fold.

If you were given a device kit at your physician’s office you should complete the set-up process within 24 hours. If your physician arranged to have you receive your device at home, compete the set-up process the same day. Complete instructions are located in your monitoring kit.

Yes, follow your normal daily routine as directed by your physician

Charges are incurred when you begin monitoring. During or after your service, your insurance company will send you an Explanation of Benefits (EOB). An EOB from your insurance carrier is NOT a bill. For details regarding the specifics of your plan, please contact your insurance company.

References:
1 Sposato LA, Cipriano LE, Saposnik G, et al. Diagnosis of atrial fibrillation after stroke and transient ischaemic attack: a systematic review and meta-analysis. The Lancet Neurology. 2015;14:377–387
2 Medic G, Kotsopoulos N, Connolly MP, Lavelle J, Norlock V, Wadhwa M, Mohr BA, Derkac WM. Mobile Cardiac Outpatient Telemetry Patch vs Implantable Loop Recorder in Cryptogenic Stroke Patients in the US – Cost-Minimization Model. Med Devices (Auckl). 2021;14:445-458. https://doi.org/10.2147/MDER.S337142
3 Based on MIT-BIH (Massachusetts Institute of Technology-Beth Israel Hospital) Arrhythmia Database testing of ≥30-second AF episodes. (FDA 510k submission)
4 Kernan, WN, et al. Guidelines for the Prevention of Stroke in Patients with Stroke and Transient Ischemic Attack: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. STROKE. July, 2014; p.5.