Many patients with the abnormal heart rhythm known as atrial fibrillation (AF) are treated in the ER. Studies suggest that the ER provides a "teachable moment" to change behavior, says the study's lead author, Phillip Scott, M.D., an assistant professor of emergency medicine at the University of Michigan in Ann Arbor.
As an example, a teenager who comes to an emergency room after an alcohol-related motor vehicle collision is likely to be more receptive to efforts to reduce alcohol consumption and the risk of alcohol-related incidents, says Scott.
"Similar strategies to improve stroke prevention should be explored for implementation in emergency departments," he adds.
About one in 20 people with AF will suffer a stroke each year, says Scott. In AF, the heart's two upper chambers quiver instead of beating, allowing blood to pool and clot instead of being pumped to the rest of the body. If a clot then leaves the heart and lodges in an artery in or leading to the brain, a stroke may result.
However, regular treatment with blood-thinning agents particularly the drug warfarin can reduce this risk by almost 70 percent, Scott says. Current estimates suggest 40,000 strokes could be prevented each year by fully implementing American Heart Association recommended guidelines on AF, he says.
In a review of medical records at teaching hospitals in Cincinnati and Ann Arbor, researchers found that only 40 percent of patients with a history of AF seen in emergency departments were receiving warfarin and 5 percent were receiving warfarin plus aspirin. Twenty-eight percent were taking
Contact: Carole Bullock
American Heart Association