Keep the Beat and Prevent Strokes

A fluttering in your heart or a rapid, irregular heartbeat could be a sign of arrhythmia, or abnormal heart rhythm.

Often, abnormal heartbeats cause no harm. But the most common type of abnormal heart rhythm, atrial fibrillation (A Fib), is considered a major risk factor for stroke. And the American Heart Association reports that stroke is the leading cause of preventable disability.

The good news: Your physician or health care provider can assess your degree of stroke risk from A Fib, says neurologist Esteban Cheng-Ching, MD, of the Clinical Neuroscience Institute of Premier Health Specialists. And your physician can help you lower the risk.

“Atrial fibrillation can increase your risk of stroke fivefold, and one-third of A Fib patients actually have a stroke,” Dr. Ching said.

“Physicians use different tools to assess stroke risk in A Fib patients that factor in contributing risks such as high blood pressure, high cholesterol, diabetes, obesity and smoking,” Dr. Ching says.

How Does A Fib Raise Stroke Risk?

Mark Krebs, MD, of Miami Valley Cardiologists explains that A Fib’s irregular rhythm alters blood flow through the heart’s upper chambers, the atria. Blood pools in the corners of the atria, specifically the left atrial appendage, a small pouch that empties into the left atrium, where it can form clots. These clots can dislodge from the heart and travel to other parts of the body.

Click play to watch the video or read the transcript.

Does having atrial fibrillation (A Fib) increase the risk of stroke?

Atrial fibrillation carries a risk of stroke. The heart, when it is in atrial fibrillation, the top chambers, or the atrium, are more or less just quivering, and blood flow through the top chambers does not move as efficiently as it would in a normal rhythm or in sinus rhythm. In this scenario, blood tends to pool in the corners of the heart and when that happens, clots can form. Those clots, if they dislodge from the heart, can land in other areas of the body. In a sense, approximately 50 percent of the blood flow goes to the head, so a stroke is probably the most common scenario that these blood clots can cause. The risk of a stroke can range anywhere from two to three percent in some individuals. And those with higher risk factors for stroke can be upwards of ten to 15 percent per year.

 

As about half of blood flow from the heart goes to the head and brain, stroke is a major consequence of A Fib-related clots, Dr. Krebs explains. These clots block blood and oxygen from the brain.

When Should You See Your Doctor?

Dr. Ching advises that symptoms of A Fib may include significant palpitations, light-headedness, chest pain, fatigue or shortness of breath. “Any symptoms should prompt a visit with your primary care physician, who can conduct a screening for the symptoms and tests — such as an EKG or a Holter monitor — to check heart rhythm.”

Patients with other risk factors such as high blood pressure, diabetes, high cholesterol, smoking, and obesity are at higher risk of developing A Fib and should be tested more often, he adds.

Treatment Options for Lowering Stroke Risk

If your A-Fib-related stroke risk is high, your doctor has treatment options to choose from to lower the risk, based on your diagnosis.Keep the Beat and Prevent Strokes - In Content

These include a variety of blood-thinning medications, or anticoagulants, which prevent formation of blood clots.

Dr. Ching said, “Several new blood thinners have been approved by the FDA in recent years, so there are more options now for patients. Some of these medications don’t require as much blood monitoring and lab monitoring as previous medications.”

Your doctor or health care provider may also prescribe medications to treat the A Fib and return your heart to a normal rhythm, and other medicines to slow the heartbeat. In some cases, surgical procedures may be used to bring the heart back to normal rhythm.

Another option to reduce the risk of stroke is the WATCHMAN™ Left Atrial Appendage (LAA) Closure Device. In patients with A Fib, it’s believed that most clots that cause stroke originate in the heart’s left atrial appendage. The WATCHMAN™ Device closes off the appendage to prevent harmful blood clots from entering the bloodstream and potentially causing a stroke. Over time, patients with the device may be able to stop taking the blood thinner warfarin.

The Risks of Not Treating A-Fib

Untreated, A Fib can lead to strokes that can be fatal or disabling. “Atrial fibrillation can increase your risk of stroke fivefold, and one-third of A Fib patients actually have a stroke,” Dr. Ching said. “This increases if you have other risk factors such as high blood pressure, smoking, obesity and high cholesterol.”

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