ATRIAL FIBRILLATION AND STROKE RISK

Atrial Fibrillation and Stroke Risk

A-fib can lead to blood clots in the upper chambers of the heart increasing the risk of having a stroke fivefold.

By D.S. Mitchell

Costco Connection

I am a Costco member and as such I get a copy of the Costco Connection magazine every month. The publication is full of useful information. In the February 2023 issue, I found a great article by Andrea Downing Peck, on the dangers of atrial fibrillation, a very dangerous heart rhythm disorder. I’m a retired RN and I’m always looking for information that will help people recognize symptoms of dangerous health conditions.

Kareem Abdul-Jabbar

Recently, I have seen numerous public service announcements made by NBA basketball legend Kareem Abdul-Jabbar who tells us that he suffers from atrial fibrillation. Well Kareem is not alone; an estimated 2.7 million American live with atrial fibrillation (a-fib). A-fib is the most common sustained heart rhythm disorder seen by doctors.

What Is A-Fib?

A-fib is an irregular, disorganized heart rhythm where the heart’s upper chambers (the atria) no longer beat in coordination with the lower chambers (the ventricles). The rate is usually more rapid than would normally be expected for the level of activity being engaged in.  A-fib is extremely dangerous because the rhythm commonly causes blood clots and blood clots cause strokes. Patients may experience a-fib without symptoms, but when symptoms do appear they may include chest discomfort, light-headedness, palpitations, shortness of breath, and fatigue. If left untreated it can be deadly.

Common Victims

The risk for a-fib increases after age 65. Several medical conditions also increase the risk of developing a-fib whether you are young or old: High blood pressure, Sleep apnea, Obesity, Heart failure, Diabetes, Overactive thyroid, Pericarditis, and coronary artery disease.

Triggers

Lots of studies and research have been done over the last fifty years to discover how to prevent heart disease. Researchers have known that the risk of coronary disease increases with predictable lifestyle factors. Now much of that research is telling us that those same factors and prevention strategies are most likely relevant to heart rhythm disturbances such as a-fib.

Alcohol vs Caffeine

Caffeine has been suspected as a trigger in patients who experience intermittent a-fib. Intermittent a-fib is defined as a temporary episode of the disorder that starts suddenly but resolves quickly without medical interventions, usually within 24 hours. The studies clearly indicate that caffeine does not appear to increase episodes of a-fib, but alcohol did frequently act as a trigger. Drinking more than one alcoholic beverage per day is clearly a trigger for the disorder.

More Than One Trigger

Smoking, sleeplessness, dehydration, stress, obesity, high blood pressure, and sedentary lifestyle are factors that seem to trigger a-fib events. The caveat here, as with many things, it is often a combination of several factors that trigger the event. Over the next several decades the prevalence of a-fib is expected to increase significantly. It’s the combination of these co-morbidities that increase the risk of a-fib.

The Answer

There’s an epidemic of obesity, Type 2 diabetes, inactivity, and alcohol abuse, in the United States. According to experts, we need the population to move, lose weight, drink less alcohol, and as practitioners, doctors need to aggressively treat diabetes and high blood pressure.

Treatment

 Treatments can vary. Medication or surgical intervention, in some cases, may be required. Medications are used to control heart rate and rhythm. Anti-coagulants are used to prevent clotting. A cardioversion is sometimes used as an emergency intervention. A catheter ablation is a procedure used to permanently restore the heart’s proper electrical currents.  There is also for some patients an implant called the Watchman that offers an alternative to blood thinners.

Outcomes

It is important to educate the public about a-fib and other heart rhythm disorders. It is important that if an individual is experiencing symptoms, they should contact their physician as soon as possible to diagnose the problem and above all prevent stroke.