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Stroke Smart Magazine


March/April 2008
PREVENTION

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Beat the Odds


By Pete Lewis

Atrial fibrillation, a type of irregular heartbeat also called A Fib or AF, can dramatically increase your odds for another stroke. But, there are things you can do to manage this heart condition and reduce stroke risk.


A Fib affects more than 2.2 million Americans, or one percent of the population, and causes about 15 percent of all strokes.


People with atrial fibrillation, or A Fib, are six times more likely to have a stroke than those without the condition. Strokes caused by A Fib tend to be more severe and are more likely to be fatal. In fact, 70 percent of stroke patients with A Fib die as a result of their strokes. Those who survive are more likely to have another stroke than patients who survive other types of strokes.


Your chances of having A Fib increase as you age. About five percent of Americans 65 and older have the condition. The symptoms of atrial fibrillation can be very subtle and difficult to detect. In fact, about one third of all cases go undiagnosed.


The heart is a muscle that pumps blood by contracting. These contractions are controlled by electrical impulses. With atrial fibrillation the impulses are irregular, disorganized, chaotic and very rapid. This causes the two upper chambers of the heart (the atria) to flutter or quiver rather than contract effectively so that blood is not pumped completely out of the chambers with each beat. The blood that remains in the chamber can clot and if these clots break away and travel out of the heart through the blood stream, they can eventually block an artery that feeds the brain and cause a stroke.


Strokes caused by atrial fibrillation can be harder to treat than strokes caused by clots formed in blood vessels because clots can sit longer in the heart so they’re often larger and more resistant to clotbusting drugs or surgery.


The most effective and most common treatment for atrial fibrillation is anticoagulant medicine. Sometimes called “blood thinners,” these drugs can reduce the blood’s capacity to form clots. Warfarin, also known by the brand name Coumadin®, is a common anticoagulant prescribed to reduce stroke risk. Aspirin also is sometimes prescribed.


“An anticoagulant like Coumadin® can decrease the risk of a stroke by two thirds,” said Dr. Don Smith, Stroke Program Medical Director at Colorado Neurological Institute in Denver, Colo. “Aspirin can cut stroke risk by 20 percent.”


Anticoagulants, including aspirin, have some risks and their effectiveness is influenced by diet and by other medicines, so it’s important to follow your doctor’s instructions and have your blood tested periodically.


“Atrial fibrillation is an important stroke risk that increases with age, but while it usually is not a curable problem, it is modifiable,” Smith said.


A Fib patients sometimes are prescribed drugs to slow their heart rate or restore rhythmic heart patterns. In some cases, surgery, electronic stimulation or an electronic pacemaker can eliminate the irregular heartbeats. But Smith said only anticoagulants have been shown to significantly reduce stroke risk.



 


  

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