IN RHYTHM

ECU doctoral student secures national grant to screen area residents for stroke risk

An East Carolina University doctoral student in clinical health psychology has secured one of eight national grants from the Heart Rhythm Society to screen area residents for atrial fibrillation (AFib) and stroke risk using smartphone electrocardiogram (ECG) technology.

Caley Kropp earned the $20,000 AFib Screening Initiative grant on behalf of the Department of Psychology to use FDA-approved, smartphone-based ECG technology. He and his team will administer community-based screenings for AFib, a predominant stroke risk factor, at area pharmacies. People who have common risk factors for stroke—including obesity, sleep apnea, hypertension and diabetes—will be given screenings, education and other resources to address those problems.

Kropp’s co-investigators include Dr. Ashley Burch, an experimental psychologist who recently completed a post-doctoral position at ECU, is a research associate professor at and fellow doctoral student Nichelle Huber. Under the guidance of Dr. Samuel F. Sears, professor in the departments of psychology and cardiovascular sciences and director of doctoral studies in the Department of Psychology, at least 250 volunteer participants will be screened at rural pharmacies in Greenville, Ayden, Wilson and beyond during the next six months. Participants will also be provided education on atrial fibrillation, and, if necessary, referrals to primary care and/or heart-health specialists.

“When I first heard we had been awarded the grant, I was excited and just really proud of our research team,” Kropp said. “This is a home run for us because we’re looking to become more involved in AFib research. We put together what we thought would be the best plan to screen as many people as possible in a rural setting.”

Participants—who have not been previously diagnosed with atrial fibrillation but have two or more risk factors—will be screened using AliveCor Incorporated’s Kardia Mobile device, which connects to a smartphone and takes a 1-lead ECG at the participant’s fingertips in just 30 seconds. The students will be able to detect atrial fibrillation from the reading, raising a nearly instantaneous red flag for those at high risk for strokes.

“We have never done anything like this before,” Kropp said, “but the pharmacies that we have spoken to seem to think there will be a lot of interest and a lot of buy-in from community members. Many individuals in our region are vulnerable from a health care perspective, and it is unlikely that they would have access to this technology unless it was through a university sponsored research program.”

ECU graduate student Caley Kropp holds an electrocardiogram that can be used with a mobile tablet to monitor a person’s heart rhythm and risk for stroke. (Photo by Rhett Butler)

Atrial fibrillation is a quivering or irregular heartbeat (arrhythmia) that can lead to blood clots, stroke, heart failure and other heart-related complications. According to the American Heart Association, at least 2.7 million Americans are living with AFib, which is a hot topic in the medical community as it is thought to be highly preventable. Atrial fibrillation is associated with a five-time increased risk of stroke and a three-time increased risk of dementia, and impacts the U.S. health care market with more than $20 billion in associated costs per year. North Carolina, especially the eastern region, is part of the nation’s “Stroke Belt” and is associated with high rates of morbidity and mortality.

“I’m most excited because we have the opportunity to improve the lives of people in eastern North Carolina,” Kropp said. “Even if we can prevent one stroke or empower one person to be more engaged in their health care, the project will be worth it.”
Kropp and Huber are studying under Sears, who is widely known as the leading international expert on the psychological aspects of patients with implantable cardioverter defibrillators (ICDs). Burch, an experimental psychologist who recently completed a post-doctoral position with Sears, is a research associate professor at ECU. Huber has spearheaded recruitment efforts and developed partnerships with local pharmacies.

“Dr. Sears is an expert in the field, a great teacher, and an inspirational mentor,” Kropp said. “He instills confidence in us with his breadth of knowledge and his investment in us as scientist-practitioners in training.”
Sears and his team continue to be pioneers of the little-known field of cardiac psychology by exploring the effects of medical technology on the quality of life of heart patients and their families.

“Caley’s work to secure this grant is beneficial not only for our institution, but for patients in our region and state,” Sears said. “The grant application process and the study itself represent a unique process of blending clinical research with clinical training to produce a win for ECU and a win for patients who are at risk for strokes.”

Kropp and Burch said the study aligns perfectly with ECU’s mission of service. The grant will allow them not only to screen participants, but to offer valuable education in a setting where they already feel comfortable and cared for.

“In addition to screening individuals for AFib, a primary objective of this initiative is education,” Burch said. “Being able to promote health literacy surrounding such a significant health concern is evidence of the Department of Psychology’s commitment to ECU’s mission of promoting wellness and reducing health disparities in our community.”

The study, Kropp said, will also allow the department to build community partnerships that prove beneficial for future research and wellness education efforts.

“This shows that we have a dedication to research that directly impacts residents of eastern North Carolina and beyond,” Kropp said. “We are hoping to bridge the gap between rural health, primary care and psychological treatments. It further shows that East Carolina is not just a small school at the edge of the state; it is a leader in innovative health care solutions.”

The Heart Rhythm Society is the international leader in science, education and advocacy for cardiac arrhythmia professionals and patients. Also awarded AFib Screening Initiative grants are the Mayo Clinic Rochester; the Ohio State University Ross Heart Hospital; University of Massachusetts Medical School; the Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University of Buffalo; Wellness Center at Eastern Idaho Regional Medical Center; North Ohio Heart Center; and Edward-Elmhurst Healthcare, Illinois.

ECU graduate student Caley Kropp demonstrates how a mobile tablet and electrocardiogram can be used to monitor a person’s heart rhythm and risk for stroke. (Photo by Rhett Butler)