Early detection of post-stroke AF with comprehensive monitoring program
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.
100 %
≥30-second AF episodes. 3
5x better
8x lower
Philips BioTel Heart Post-Crypotgenic Stroke Pathway
Detection of AF in post-cryptogenic stroke patient with a diagnosis of 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
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
Study Results
- An initial strategy of 30-day electrocardiogram (ECG) monitoring with MCOT patch in diagnosis of AF in cryptogenic stroke patients realizes significant cost-savings compared to proceeding directly to ILR only.
- In the base case modeling, the MCOT patch arm detected 4.6 more patients with AFs compared to the ILR alone arm in a cohort of 1000 patients (209 vs 45 patients with detected AFs, respectively).
- Using MCOT patch followed by ILR in half of the patients initially undiagnosed with AF leads to significant cost savings of US$4,083,214 compared to ILR alone in a cohort of 1000 patients.
- Cost per patient with detected AF was significantly lower in the MCOT patch arm $29,598 vs $228,507 in the ILR only arm.
- 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.
- These results strengthen emerging recommendations for prolonged ECG monitoring in secondary stroke prevention.
MCOT
Atrial fibrillation detected by Mobile Cardiac Outpatient Telemetry (MCOT) in cryptogenic TIA or stroke
Authors
Source
Volume 71, Number 21, November 2008
Study Results
- 68 patients in a single center study —retrospective analysis of patients who underwent a 21 day MCOT.
- AF was detected in 13/56 patients = 23%.
- 5.3% of patients had runs of AF >30 seconds in duration.
- 85% of patients had runs of AF
ATRIAL FIBRILLATION IN CRYPTOGENIC STROKE
Outpatient cardiac telemetry detects a high rate of atrial fibrillation in cryptogenic stroke
Authors
Source
Study Results
- Retrospective analysis of all MCOT records for a period of 18 months (June 2009-January 2011) prescribed by Neurologists at a single Stroke Center.
- AF detected in 27 of 156 patients = 17.3%.
- Two-thirds (n=18) developed episodes of PAF lasting less than 30 seconds.
- 26% (n=7) lasting equal to or greater than 30 seconds.
- 7% (n=2) had persistent AF.
- Mean time to first occurrence of AF was 8.8 days.
- Rate of PAF detection significantly increased from:
- 3.9% in the initial 48 hours to
- 9.2% at 7 days,
- 15.1% at 14 days, and
- 19.5% by 21 days
- MCOT provides a high rate of detection of AF in patients with cryptogenic stroke or TIA, and length of monitoring time is strongly associated with an increase in detection rate.
UNIVERSITY OF PENNSYLVANIA STUDY
Predictors of finding occult atrial fibrillation after cryptogenic stroke
Authors
Source
Study Results
- 28-day MCOT detected AF in a substantial proportion (14%) of cryptogenic stroke patients.
- 250 patients in a single center study - retrospective analysis of patients who underwent a 28 day MCOT.
- 84% (26 patients) were anticoagulated regardless of AF episode duration. All patients without bleeding history were offered anticoagulation regardless of duration of AF.
CASE-CONTROL STUDY
Paroxysmal atrial fibrillation in cryptogenic stroke
Authors
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
Study Results
- 128 patients enrolled within 3 months of suffering first stroke.
- Paroxysmal Atrial Fibrillation (PAF) of any duration detected in 25% of total patients with MCOT monitoring.
- ALL episodes were asymptomatic.
- Nearly 20% of all patients (1 in 5) had AF detected in
Frequently Asked Questions
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.