| Autor: |
Chun Ka Wong, Jo Jo Hai, Yuk-Ming Lau, Mi Zhou, Hin-Wai LUI, Kui Kai Lau, Koon-Ho Chan, Toi Meng Mok, Yong Liu, Yingqing Feng, Ning Tan, Weng-Chio Tam, Kun-Chong Tam, Xiuhua Feng, Ming-Liang Zuo, Li-Xue Yin, Jing Tan, Wen-Jun Zhang, Xiaofei Jiang, Xiaoyu Huang, Jianfeng Ye, Yan Liang, Wei Jiang, Zhen Lei, Duo Huang, Wen-Sheng Yue, Guanming Tan, Bryan P Yan, Mario Alberto Evora, Ji-yan Chen, Chung-Wah Siu |
| Rok vydání: |
2022 |
| Předmět: |
|
| Zdroj: |
BMJ open. 12(7) |
| ISSN: |
2044-6055 |
| Popis: |
IntroductionCurrent international guidelines recommend ECG monitoring after an ischaemic stroke to detect atrial fibrillation (AF) in order to prevent stroke recurrence. However, optimal strategies to detect AF and the downstream management to prevent stroke recurrence remain to be established. The objective of the study was to explore the use of long-term home-based ECG monitoring for AF detection and stroke prevention in patients with a history of stroke.Methods and analysisThis prospective, randomised, open-label trial with blinded endpoint adjudication aimed to evaluate the efficacy of long-term home-based ECG monitoring for AF detection and stroke prevention in a 24-month period. Patients aged >18 years with a history of ischaemic stroke will be stratified according to the time from the index ischaemic stroke: 3 years and then randomised in 1:1 to (1) home-based AF screening and (2) control. The home-based AF screening system comprises (1) a handheld single-lead ECG recorder (Comfit Healthcare Devices, Hong Kong SAR, China) and (2) a patient-facing smartphone application specially designed for the study. Patients randomised to the home-based AF group will record a 30 s single-lead ECG using a specially designed handheld ECG device every morning or when symptomatic. All remotely obtained data will be automatically transmitted in real-time through the study smartphone application to a secured cloud hosting and analysed using an artificial intelligence-based diagnostic system. When a diagnosis of AF is made with the system, the patients will be called back for a formal cardiology consultation within 1 week. The primary endpoint is the time to first detection of AF at 24 months of follow-up. Secondary endpoints include recurrent stroke or transient ischaemic attack, initiation of long-term anticoagulation therapy, hospitalisation for heart failure, cardiovascular death and all-cause death.Ethics and disseminationThe study protocol has been approved by the institutional review board of The University of Hong Kong, and Hong Kong West Cluster, Hospital Authority, Hong Kong SAR, China. Results will be published in peer-reviewed journals.Trial registration numberNCT04523649. |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
|
