Latest advances in stroke prevention replace older, less reliable methods. However, nearly half the country is still 10 years behind the times, says cardiologist Joshua S. Yamamoto, medical director at Foxhall Medicine in Washington, DC.
According to Dr. Yamamoto, the four major advancements everyone should know about are—
- The implantable cardiac monitor (made by Abbott/St Jude), which is a paper-clip-sized micro-chip that continuously monitors your heart and remotely alerts your doctor about significant irregularities. “This is truly superior to the clunky wearable gear from the past,” says Dr. Yamamoto. As of 2019, it’s Medicare-approved for in-office insertion. No preparation necessary.
- “DOACs,” Direct Oral Anti Coagulants. This new class of “stroke prevention medications” is a million miles ahead of the old meds, like Warfarin/Coumadin. This is not your Father’s Oldsmobile! The new meds are revolutionary. Here are the main benefits
- Superior at preventing strokes
- Lower bleeding complications
- Have a stable dose that doesn’t require lab tests or constant adjustments (Nearly half the people taking Coumadin are not on the right dose, especially as the dose can change from week to week depending on your diet)
- Starts immediately and stops or can be turned off quickly (Warfarin takes days to start and days to “reverse”)
- Excellent absorption and efficacy with once-daily dosing
- The only medications that prevent strokes for both atrial fibrillation AND arterial disease
- High resolution ultrasound (like for carotid studies) are much better than old-school imaging and can show disease progression. “In other words,” says Yamamoto, “this tech will let you know not just when to start treatment, but whether the treatment you are on is working well enough (for you) – all non-invasively and without radiation.”
- Functional testing, i.e., an exercise echocardiogram is an improvement on standard stress testing. “It is never just a pass/fail prospect. It tells you how effective your current therapy is and enables you to make adjustments.” You don’t have to be an elite athlete to have a functional test, and again, there’s no invasive procedures, dye, injections or radiation.
