Checking pulse could help detect risk of a second stroke

Jul 24 2014, 10:16 IST
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SummaryStroke patients and their families can be taught to monitor the patient’s pulse...

Stroke patients and their families can be taught to monitor the patient’s pulse and detect irregular heartbeats that might lead to another stroke, according to a new study.

Of people who have a stroke, 40% will suffer another one within the next 10 years, said lead author Dr. Bernd Kallmunzer of the Department of Neurology at Universitatsklinikum Erlangen in Germany.

Taking a pulse reading can detect atrial fibrillation, a major risk factor for stroke, and facilitate appropriate treatment to reduce the risk of another stroke or death, Kallmunzer told Reuters Health by email.

The study team tested how accurately patients and their families could detect fibrillation just by taking a pulse.

The study, online July 23 in Neurology, included 256 patients who had suffered a first stroke and were treated at the authors’ stroke unit in Germany in late 2012 or early 2013. While still hospitalized, the patients and in some cases also their relatives were taught to take pulse readings from the radial artery in the left wrist.

The patients and families were also given printed instruction materials and a stopwatch.

During the half-hour tutorial, patients were taught to use the stopwatch to measure pulse rate and to recognize a normal pulse sensation and an irregular sensation that may indicate atrial fibrillation.

Atrial fibrillation feels like a ‘stumbling’ rhythm and may be faster than 100 beats per minute or slower than 50, Kallmunzer said. A normal heartbeat is rhythmic and regular and only changes slightly on inhale and exhale.

The patients were then hooked up to an electrical heart monitor and the screen was covered. A healthcare professional, the patient and the patient’s family all attempted to take a pulse reading.

According to the electrical heart monitor, 172 of the patients had normal heart rhythms and 57 had atrial fibrillations – the rest had another kind of abnormal rhythm. The researchers analyzed how often wrist pulse readings achieved the same result as the electrical heart monitor.

Almost 90% of the patients who were mentally able did complete a pulse reading on themselves, and correctly detected 54% of the atrial fibrillations. Health care providers detected 97% of atrial fibrillations.

Only six patients who thought their heart rates were irregular were incorrect. A false-positive rate that low is encouraging, the authors write.

Among patients with atrial fibrillation whose family members took the tutorial, relatives detected the irregular beats 77% of the time by taking the patient’s pulse.

When atrial fibrillation is detected, medication can

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