CLINICAL TRIAL

Atrial fibrillation risk electronic health record alert for Atrial Fibrillation

Recruiting · 18+ · All Sexes · Boston, MA

Precision Medicine in Ischemic Stroke and Atrial Fibrillation

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About the trial for Atrial Fibrillation

Eligible Conditions
Ischemia · Stroke · Ischemic Stroke · Cerebral Infarction · Atrial Fibrillation

Treatment Groups

This trial involves 2 different treatments. Atrial Fibrillation Risk Electronic Health Record Alert is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are not being studied for commercial purposes.

Main TreatmentA portion of participants receive this new treatment to see if it outperforms the control.
Atrial fibrillation risk electronic health record alert
OTHER
Control TreatmentAnother portion of participants receive the standard treatment to act as a baseline.

Eligibility

This trial is for patients born any sex aged 18 and older. There are 2 eligibility criteria to participate in this trial as listed below.

Inclusion & Exclusion Checklist
Mark “yes” if the following statements are true for you:
Patients aged 18 years or older
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Odds of Eligibility
Unknown<50%
Be sure to apply to 2-3 other trials, as you have a low likelihood of qualifying for this one.Apply To This Trial
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Approximate Timelines

Please note that timelines for treatment and screening will vary by patient
Screening: ~3 weeks
Treatment: varies
Reporting: 12-months
This trial has approximate timelines as follows: 3 weeks for initial screening, variable treatment timelines, and reporting: 12-months.
View detailed reporting requirements
Trial Expert
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- What options you have available- The pros & cons of this trial
- Whether you're likely to qualify- What the enrollment process looks like

Measurement Requirements

This trial is evaluating whether Atrial fibrillation risk electronic health record alert will improve 1 primary outcome and 8 secondary outcomes in patients with Atrial Fibrillation. Measurement will happen over the course of 1-month.

Proportion of patients with cardiac monitor ordered by neurologist
1-MONTH
Proportion of patients with cardiac monitor ordered by the neurologist at discharge. Cardiac monitor orders by the neurologist will be ascertained based on electronic health record documentation.
Proportion of patients with transesophageal echocardiogram utilization
3-MONTHS
Proportion of patients with transesophageal echocardiogram (TEE) within 3-months of discharge for acute ischemic stroke. Transesophageal echocardiogram utilization will be ascertained based on electronic health record documentation.
Incidence of cardiac rhythm monitoring
6-MONTHS
Incidence of any cardiac rhythm monitoring in the 6-month follow-up period following discharge for an acute ischemic stroke. Cardiac rhythm monitoring will be ascertained based on electronic health record documentation.
Proportion of patients with ambulatory wearable cardiac rhythm monitoring orders
12-MONTHS
Proportion of patients with wearable cardiac rhythm monitor ordered at discharge, 6-months, and 12-months. Wearable cardiac rhythm monitoring orders will be ascertained based on electronic health record documentation.
Proportion of patients with recurrent stroke
12-MONTHS
Proportion of patients with recurrent stroke occurring within 12-months of discharge for an initial acute ischemic stroke. Recurrent stroke will be ascertained based on electronic health record documentation.
Proportion of patients with a new atrial fibrillation diagnosis
12-MONTHS
Proportion of patients with a new diagnosis of atrial fibrillation at 12-months following discharge for acute ischemic stroke based on electronic health record documentation.
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Who is running the study

Principal Investigator
S. A. L.
Prof. Steven A Lubitz, Associate Professor
Massachusetts General Hospital

Patient Q & A Section

Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

Can atrial fibrillation be cured?

Although AF does not currently have a defined treatment target, recent developments in cardioversion strategies should result in increased use of cardioversion as a first-line intervention.

Anonymous Patient Answer

What causes atrial fibrillation?

The mechanism of the initiation of AF from focal electrical activity is incompletely understood. However, since the electrical activity of the atria are intimately linked and are activated and suppressed by the same autonomic pathways, it is unlikely that a single mechanism can cause both initiation and perpetuation of AF. A more comprehensive understanding of the multiple, possibly interlinked, underlying mechanisms that cause atrial fibrillation may illuminate novel potential therapeutic targets.

Anonymous Patient Answer

What are the signs of atrial fibrillation?

Some signs of atrial fibrillation include symptoms, such as palpation pain or weakness in the left upper chest. The presence of mitral regurgitation (>or = 1/4 of the diameter) or a first degree atrioventricular block (posterior inferior or posterior lateral wall) increases the risk of atrial fibrillation.

Anonymous Patient Answer

What is atrial fibrillation?

Atrial fibrillation accounts for millions of cases of dyspnea and stroke in the USA. This article describes the characteristics and clinical use of this disorder.

Anonymous Patient Answer

How many people get atrial fibrillation a year in the United States?

Atrial fibrillation is common and costly. Although the overall incidence of AF has been declining, there have been no significant reductions in hospital visit rates; there is also uncertainty about the impact of AF on long-term mortality and quality-of-life outcomes.

Anonymous Patient Answer

What are common treatments for atrial fibrillation?

The use of catheter ablation for AF is common despite the lack of evidence for its safety and efficacy. Results from a recent paper, 28% of patients undergo surgical ablation of the substrate of their AF.

Anonymous Patient Answer

What does atrial fibrillation risk electronic health record alert usually treat?

Atrial fibrillation is more likely in patients with prior diagnoses of congestive heart failure, diabetes mellitus, hypertension, or alcohol abuse. The magnitude of the alerts is similar to previously published reports in the literature.

Anonymous Patient Answer

What are the common side effects of atrial fibrillation risk electronic health record alert?

More than one-third of atrial fibrillation patients report multiple atrial fibrillation warning criteria on their medical record alerts. The most commonly reported side effects of atrial fibrillation, which have been reported in ≥10% of all alert patients, are headache (28%), flushing (20%), tachycardia (15%) and fatigue (13%) (P<0.05 for all). The number of side effects associated with atrial fibrillation alerts should be decreased by modifying the trigger criterion to a more inclusive criteria and by changing the recommendation for use of beta-blockers in the patient management of atrial fibrillation.

Anonymous Patient Answer

Who should consider clinical trials for atrial fibrillation?

Most patients with atrial fibrillation lack sufficient knowledge to make valid treatment decisions. Inadequate knowledge is primarily associated with age and gender, but not with education, literacy or knowledge of trials. Health care professionals involved in the care of atrial fibrillation patients and their caregivers should emphasize the importance of trials and ensure that patients and their relatives are informed about them. Patients and their families should be encouraged to participate in trials for these therapies.

Anonymous Patient Answer

Have there been any new discoveries for treating atrial fibrillation?

A new drug called R-axitinib has been approved by FDA for treatment of atrial fibrillation (AF, or AFib). Results of the RE-LY trial showed an overwhelming reduction in the number of patients who were hospitalized for AF (about 28% vs. 53%; p<0.01) within 12 months of starting atrial fibrillation therapy. On the overall (all time points) rate of hospitalizations for AF was lowered by about 42% (<7%) compared with placebo (p<0.001).

Anonymous Patient Answer

What is atrial fibrillation risk electronic health record alert?

Atrial Fibrillation (AF) alerts are often confusing, often due to poor communication on their use, or misapplication which may lead to over-diagnosing and inappropriate drug prescribing, and potentially leading to adverse consequences and unnecessary expenditure. Data from a recent study describes atrial fibrillation screening in the outpatient setting, suggesting more rigorous patient counseling and a clearer message from EHR is needed. All providers (e.g. internal medicine, obstetrics/gynecology, rehabilitation, emergency departments, etc.) will need access to more information and clearer guidelines for implementing an e-learning curriculum in their department.

Anonymous Patient Answer

What is the average age someone gets atrial fibrillation?

Atrial fibrillation is diagnosed in a subset of patients in the U.S. with increased frequency, particularly in older adults. The older age at initial diagnosis suggests that AF is under-recognized in this population and would be especially interesting to explore with more population-based studies.

Anonymous Patient Answer
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