The Doctors Are In: Clear link between stroke and atrial fibrillation
By Saumil Oza
Many medical cause-and-effect relationships can be complicated as medical conditions can stem from various sources but, in some cases, the connection is clear. The link between stroke and atrial fibrillation (Afib) is a shining example of two seemingly unrelated conditions that share an undeniable bond.
Once you learn more about each condition, the connection between them — as well as prevention ideas — are evident.
Every 40 seconds, someone in the United States suffers a stroke, a debilitating event in which blood flow to the brain is abruptly interrupted.
This “brain attack” results in the death of brain cells because of a lack of oxygen, often killing victims or leaving them severely disabled. In fact, the American Stroke Association reports that more than 130,000 people die from stroke in the United States each year.
There are two main types of strokes — hemorrhagic and ischemic. Hemorrhagic stroke takes place when a blood vessel leaks or ruptures. The more common ischemic stroke occurs when an artery to the brain is blocked or narrowed by a blood clot.
Afib is the most common type of abnormal heart rhythm in the country, with more than 2 million Americans affected.
Those who battle this heart disease suffer from a rapid and disorganized heartbeat that occurs in the upper chambers of the heart (the atria). During an Afib episode, the atria may beat between 350 and 600 times per minute, compared to the normal 50 to 100 beats per minute, making that segment of the heart appear to flutter or quiver.
The chaotic heartbeats of atrial fibrillation can come and go. Or the condition may be ongoing and require treatment, which can include medications and other interventions to try to alter the heart’s electrical system.
Most Afib patients experience symptoms such as fatigue, weakness, shortness of breath, palpitations, chest discomfort and dizziness, but the overriding concern is the elevated stroke risk. In fact, Afib sufferers may be up to five times more likely to have a stroke.
The American Heart Association reports that about 15 to 20 percent of people who suffer from stroke also have Afib. But why?
Stroke is categorized as a cerebrovascular event, which means both the brain and the vascular system are involved. Simply put, stroke is tied directly to irregular blood flow that commonly stems from heart abnormalities or conditions.
Furthermore, Afib in particular can result in the formation of blood clots in the heart, which then travel to the brain and trigger ischemic stroke. These dangerous clots are most often formed in a part of the heart called the left atrial appendage. For most patients, anticoagulation (or “blood thinners”) can significantly reduce this risk.
Those patients who cannot tolerate anticoagulation could be candidates for new treatment options to effectively reduce stroke risk by eliminating the left atrial appendage altogether. If patients cannot tolerate blood thinners, they should ask their physician about other options.
Although stroke is the fourth leading cause of death in the country and a major cause of disability, focusing on the prevention of diseases like Afib is a way to stop “brain attacks” before they begin. Pre-emptive measures include living a healthy lifestyle and maintaining normal body weight, as well as identifying and controlling conditions that put you at risk for heart disease.
Benjamin Franklin put it best when he said, “an ounce of prevention is worth a pound of cure.” Fortunately, the medical community is increasingly focused on collaborative medicine and the power of prevention — an effort that will lead to healthier, happier patients.
Saumil Oza is a cardiac electrophysiologist with the Atrial Fibrillation Institute at St. Vincent’s Medical Center Riverside. Oza also is a member of the Duval County Medical Society.