The Atrial Fibrillation and Stroke Connection
At least 2.7 million Americans are living with atrial fibrillation, and many do not know it. But having an irregular heartbeat, easily treatable, can increase your risk of having a stroke by as much as five times.
"Most people don't know they have AFib. So, if you experience shortness of breath or palpitations, you should definitely follow up with your doctor," said Hakeem Jibawi, DO, a cardiac electrophysiologist with Specialty Physicians of Illinois, LLC, who chooses to practice at Franciscan Health.
The most common symptom of atrial fibrillation is heart palpitations, often indicated by a fluttering or shuddering sensation in the chest, and an irregular heartbeat.
Other signs and symptoms of atrial fibrillation include:
- Feeling tired or weak
- Shortness of breath
- Chest pains
The likelihood of you having atrial fibrillation increases with age.
“Patients in their 30s and 40s have less than a one percent chance of having atrial fibrillation, but by the time they hit their eight decade, the chances can be around 15%,” said John W. “Trey” Moore III, MD, a cardiac electrophysiologist at Franciscan Physician Network Indiana Heart Physicians in Indianapolis. “A lot of the risk factors for atrial fibrillation come down to the common theme of stress and strain on the heart.”
Why AFib Matters
"With this condition the top chambers of the heart (atria) go into a very fast, irregular rhythm where they are essentially no longer beating, but, instead, are quivering or fibrillating at about 300 to 500 times per minute," Jibawi said. "This throws off the normal one-to-one communication between top and bottom chambers. This also slows the blood flow in the atria and can cause tiny clots to form."
Those tiny clots could be pumped out of the heart, to the brain and block the blood supply in the brain, causing a stroke. Poor pumping increases the risk of clots forming in the heart chambers, particularly the left atrial appendage, which is located on the top of the heart.
"Stroke is its most feared complication," Jibawi said.
Preventing Stroke in AFib Patients
Once diagnosed, patients with atrial fibrillation may be treated with anti-coagulation medications (or blood thinners). Older medications like warfarin (Coumadin) are still being used but there are newer anticoagulation medications that don’t require blood draws to monitor the effectiveness of the drug. These drugs reduce the likelihood of experiencing those potentially dangerous blood clots within the heart that may cause a stroke.
“A lot of patients will require blood thinners, but every good blood thinner increases risk for bleeding,” Dr. Moore said. “We have an entire team dedicated to helping patients make sure that their blood is not too thick, not too thin, but just right.”
According to the American Stroke Association, up to 80 percent of strokes in people with AFib can be prevented. Properly managing your AFib can reduce your risk of a stroke. Work with your cardiologist to develop a treatment plan for your health needs.
“In the past we used to have to pick focusing on either the risk for bleeding or the risk for stroke, but in the current era, there are new options for atrial fibrillation stroke risk reduction,” explained Dr. Moore. “We can actually close off the left atrial appendage. It’s the part of the heart where most of the clots form and we can get the majority of those patients off blood thinners all together.”
“For our patients that can’t be on anticoagulation for a specific reason, we’re able to use a device called the Watchman, which is basically a plug in the opening of the left atrial appendage, Dr. Moore said.
Heart tissue then grows over the plug and eliminates that space from the heart so blood clots can’t form there anymore.