To deal with the American accent of business stakeholders

At the start of the meeting, just politely tell them to talk a bit slowly as it is difficult to understand their accent. They will understand. They don't take it personally like Indians. Usually they are considerate. To confirm always repeat it back.

Ps. 10 yrs in IT I still find it difficult to understand australian and Irish accent.

Ask them to speak at 0.75x the speed 😄