Quality Improvement in Atrial Fibrillation detection after ischaemic stroke (QUIT-AF)

Area of Science:

• Cardiology
• Neurology
• Quality Improvement Science

Background:

• Paroxysmal atrial fibrillation (PAF) is a common cause of recurrent stroke.
• Detecting PAF is challenging due to its episodic and often asymptomatic nature.
• Early detection of PAF is crucial for stroke prevention.

Purpose of the Study:

• To enhance the detection rate of paroxysmal atrial fibrillation (PAF) in ischemic stroke patients.
• To implement early, prolonged inpatient cardiac monitoring on a stroke unit.
• To assess the effectiveness of a quality improvement project for PAF detection.

Main Methods:

• A structured protocol for 5-day inpatient event recorder cardiac monitoring was established.
• Cardiac monitoring was implemented 'in-house' on the stroke unit.
• Prospective analysis of performance data was conducted.

Main Results:

• 102 ischemic stroke patients underwent 5-day event recorder monitoring.
• Inpatient monitoring provision increased from 20% to 65.7%.
• New atrial fibrillation (AF) was detected in 14.7% of patients, with most cases identified via early monitoring.

Conclusions:

• Early and prolonged inpatient cardiac monitoring can be effectively delivered 'in-house' on stroke units.
• This approach significantly improves the detection rates of atrial fibrillation in stroke patients.
• Enhanced AF detection facilitates timely intervention and secondary stroke prevention.