Pulse monitoring post-stroke could help prevent a second stroke

by Bruce Sylvester – Researchers report that routinely monitoring the pulse of anyone who has had a stroke could detect irregular heartbeat, a major cause of second stroke. The findings were published on July 23, 2014 in the online issue of Neurology.

“Screening pulse is the method of choice for checking for irregular heartbeat for people over age 65 who have never had a stroke. Our study shows it may be a safe, effective, noninvasive and easy way to identify people who might need more thorough monitoring to prevent a second stroke,” said study author Bernd Kallmünzer, MD, of Erlangen University in Erlangen, Germany.

The investigators enrolled 256 subjects who had experienced acute ischemic stroke. The subjects and their relatives received instructions about measuring pulse to detect irregular heartbeat.

The investigators compared measurements taken by the lay participants and health care professionals, in reference to recordings of electrical activity in the heart. The recordings indicated that 57 of the subjects had irregular heartbeats.

They found that pulse measured by health care professionals had a sensitivity of nearly 97 percent and a specificity of 94 percent in detecting irregular heartbeats. “Sensitivity” is the percentage of actual positives correctly identified as positive. “Specificity” is the percentage of negatives correctly identified as negatives.

For patient relatives, sensitivity was 77 percent and specificity was 93 percent.

For patients, 89 percent performed reliable measurements with a sensitivity of 54 percent and specificity of 96 percent.

The researchers found false positives in six subjects and false negative results in 17 subjects.

“The low rate of false positives in this study shows that health care professionals, caregivers and patients can be guided to use this simple tool as a first step in helping to prevent a second stroke,” said Kallmünzer.