PMID- 36369810
OWN - NLM
STAT- MEDLINE
DCOM- 20221115
LR  - 20221123
IS  - 2042-8189 (Electronic)
IS  - 1478-2715 (Linking)
VI  - 52
IP  - 3
DP  - 2022 Sep
TI  - Improving detection and management of atrial fibrillation after ischaemic stroke 
      in Glasgow (IMPROVE-AF): A quality improvement project.
PG  - 213-219
LID - 10.1177/14782715221120133 [doi]
AB  - BACKGROUND: The use of cardiac monitoring to detect atrial fibrillation (AF) is 
      routine after ischaemic stroke but is often delayed leaving patients at risk from 
      undetected AF. We sought to improve the detection of AF by delivering early 
      prolonged 'in-house' cardiac monitoring. METHODS: We collected 3-months of data 
      of people with stroke/transient ischaemic attack (TIA), but without AF, who 
      underwent cardiac monitoring (Phase 1, pre-quality improvement project (QIP)). We 
      then implemented an 'in-house' 7-day cardiac monitoring service for 12 months 
      (Phase 2, during QIP). RESULTS: We included 244 people in Phase 1 and 172 in 
      Phase 2. In Phase 1, 232 (95%) people completed cardiac monitoring. Of these, new 
      AF was detected in 10 (4%). Median time from stroke/TIA onset to availability of 
      the monitoring report in Phase 1 was 50 (interquartile range (IQR): 24-123) days. 
      In Phase 2, 166 (97%) of people completed 7-day cardiac monitoring, with new AF 
      detected in 17 (10%). Median time from onset to availability of the report in 
      Phase 2 was 12 (IQR: 9-15) days. In people with AF detected, 'in-house' 
      monitoring reduced the time of stroke/TIA onset to anticoagulant commencement 
      from 41 (Phase 1) to 14 (Phase 2) days. DISCUSSION: The QIP has improved AF 
      detection, reduced delays associated with conventional cardiac monitoring and 
      prompted early initiation of oral anticoagulation.
FAU - Johnston, Fiona C
AU  - Johnston FC
AD  - Medical School, University of Glasgow, Glasgow, UK.
FAU - Cameron, Alan C
AU  - Cameron AC
AD  - Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, 
      UK.
FAU - Colquhoun, Elizabeth
AU  - Colquhoun E
AD  - Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, 
      UK.
FAU - Murdoch, David L
AU  - Murdoch DL
AD  - Cardiology Department, Queen Elizabeth University Hospital, Glasgow, UK.
FAU - Dawson, Jesse
AU  - Dawson J
AD  - Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, 
      UK.
FAU - Abdul-Rahim, Azmil H
AU  - Abdul-Rahim AH
AD  - Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20220822
PL  - England
TA  - J R Coll Physicians Edinb
JT  - The journal of the Royal College of Physicians of Edinburgh
JID - 101144324
SB  - IM
MH  - Humans
MH  - *Atrial Fibrillation/complications/diagnosis/drug therapy
MH  - *Ischemic Attack, Transient/complications/diagnosis/drug therapy
MH  - *Stroke/complications/diagnosis
MH  - *Brain Ischemia/complications/diagnosis
MH  - Quality Improvement
MH  - *Ischemic Stroke
OTO - NOTNLM
OT  - atrial fibrillation
OT  - cardiac monitoring
OT  - ischaemic stroke
OT  - oral anticoagulant
OT  - service improvement
EDAT- 2022/11/13 06:00
MHDA- 2022/11/16 06:00
CRDT- 2022/11/12 02:13
PHST- 2022/11/12 02:13 [entrez]
PHST- 2022/11/13 06:00 [pubmed]
PHST- 2022/11/16 06:00 [medline]
AID - 10.1177/14782715221120133 [doi]
PST - ppublish
SO  - J R Coll Physicians Edinb. 2022 Sep;52(3):213-219. doi: 
      10.1177/14782715221120133. Epub 2022 Aug 22.