Early Prolonged Ambulatory Cardiac monitoring in Stroke (EPACS)
Research type
Research Study
Full title
Early Prolonged Ambulatory Cardiac monitoring in Stroke (EPACS)
IRAS ID
184271
Contact name
James Teo
Contact email
Sponsor organisation
Kings College Hospital NHS Foundation Trust
Duration of Study in the UK
0 years, 11 months, 31 days
Research summary
Clots from the heart in irregular heart rhythm (paroxysmal atrial fibrillation, (PAF) is a frequent preventable cause of ischaemic stroke or transient ischaemic attack (TIA), but the transient nature of PAF means that a standard heart recording (ECG) or even 24-hour recording miss a significant proportion of patients. UK national guidelines do not recommend any specific form of detection of PAF after stroke so current UK practice is to perform short-duration 24-hour heart monitoring to detect PAF. Recent clinical trials (EMBRACE and CRYSTAL-AF) of long duration recordings using implantable loop recorders indicate that there is substantially more PAF to be detected but it is not currently known what is the best means to perform this monitoring in patients after cryptogenic strokes. EPACS will address this question by testing the research question whether early prolonged recording (up to 14-days) using a convenient wireless skin patch would be superior to standard clinical practice.
This study is a prospective randomized open blinded end-point (PROBE) study comparing stroke or TIA patients randomised to early prolonged cardiac monitoring using a non-invasive patch for 14-days or to standard medical practice of outpatient 24-hour heart monitoring. Diagnostic yield of both techniques in detecting PAF in stroke patients will be compared. This will be conducted in a single centre (Kings College Hospital) and patients will be recruited from hyperacute stroke units and TIA clinics run at both hospital sites (Kings College Denmark Hill and Princess Royal University Hospital).
REC name
London - Surrey Borders Research Ethics Committee
REC reference
15/LO/1534
Date of REC Opinion
21 Sep 2015
REC opinion
Favourable Opinion