Know Your Risks for AFib and Stroke

There are countless songs about a loved one making our hearts flutter or skip a beat, but when a quivering or irregular heartbeat strikes, due to a medical condition called atrial fibrillation (AFib), it’s nothing to sing about. AFib is dangerous because it not only affects the heart but also significantly increases a person’s risk for a stroke.

In recognition of September as Atrial Fibrillation Awareness Month, we’re taking a closer look at this condition and talking to two experts about what we should know about AFib and its link to stroke.

When the two atria (upper chambers of the heart) beat irregularly, their ability to pump blood to the lower chambers (ventricles) is negatively affected, causing troublesome symptoms and increasing the risk of heart-related death. Additionally, when blood doesn’t pump regularly, it can pool in the heart and create clots, which can block blood flow to the brain and lead to a stroke.

Tulio Diaz, M.D., a cardiologist and physician on the medical staff of Texas Health Dallas and Cardiology & Interventional Vascular Associates, a Texas Health Physicians Group practice, says AFib is becoming increasingly common in North Texas.

“AFib is probably one the top three common causes for consultation in my practice,” he says. “As the North Texas population gets older, the onset of atrial fibrillation is more frequent. The good news is we have new technology available at Texas Health for the treatment of AFib, with cure rates around 90 percent if treated early in the course of the disease.”

According to the Centers for Disease Control and Prevention, between 2.7 and 6.1 million Americans are currently living with AFib, and those numbers are expected to increase as the population ages. Around two percent of those under the age of 65 have AFib, while nine percent of people over 65 live with the condition, which also affects more women than men because of their longer life expectancy.

While some people with AFib experience no symptoms at all, the most common symptoms include:

  • A pulse that feels too fast, too slow, fluttering, pounding or irregular
  • Fatigue
  • Confusion
  • Dizziness, lightheadedness and/or fainting
  • Shortness of breath
  • An inability to exercise or perform strenuous tasks

Kenneth Saland, M.D., a cardiologist and physician on the medical staff of Texas Health Dallas and Cardiology & Interventional Vascular Associates, a Texas Health Physicians Group practice, explains that prompt medical attention is crucial if a person suspects they are experiencing AFib.

“It is very important to see a physician quickly once a patient is suspected of having AFib in order to determine the etiology of atrial fibrillation and to treat any potential symptoms,” he says. “Since atrial fibrillation can lead to blood clots (emboli) and stroke, it is imperative to understand an individual’s level of risk, with treatment usually involving blood thinners.”

Diaz also recommends immediate medical intervention if a patient has AFib symptoms, but also suggests that older patients should be screened for AFib at their yearly exams since some patients do not exhibit any symptoms.

“Prompt consultation is extremely important since untreated AFib can lead to congestive heart failure and stroke,” he explains. “Patients should pay attention to constitutional symptoms such as weakness and fatigue. About 60 percent of patients never experience symptoms and AFib is found on a routine EKG. As patients get older, the incidence of AFib increases exponentially, so it is important to have an EKG as part of a yearly physical exam.”

The National Heart, Lung, and Blood Institute reports the following risk factors for AFib:

  • Advanced age
  • High blood pressure
  • Heart failure, coronary heart disease or rheumatic heart disease
  • Congenital or structural heart defects
  • Pericarditis
  • Sick sinus syndrome
  • Hyperthyroidism
  • Obesity
  • Diabetes
  • Lung disease
  • Sleep apnea
  • Metabolic syndrome
  • High dose steroid therapy
  • Heavy alcohol use
  • Caffeine consumption
  • Psychological stress
  • Recent surgery
  • During a heart attack
  • Genetic factors

According to the American Heart Association (AHA), untreated atrial fibrillation doubles the risk of heart-related deaths and results in five times the risk for stroke. In fact, 15 to 20 percent of patients who suffer strokes have AFib.

Saland explains how AFib can lead to stroke.

“The most feared complication of atrial fibrillation is a stroke,” he says. “The irregular heartbeats associated with atrial fibrillation can cause blood to pool in the heart and potentially form a clot. This clot could travel to the brain and block blood flow, causing a stroke. This type of stroke is called a cardioembolic stroke.

“The risk of stroke in atrial fibrillation depends on your age (higher risk with age) and on other risk factors such as hypertension, diabetes, a history of heart failure or previous stroke. In most patients with atrial fibrillation blood thinners are prescribed, which can greatly lower the risk of stroke.”

If a patient is diagnosed with atrial fibrillation, the course of treatment will often depend on his or her risk factors. If a risk factor is found to contribute to the condition, treating the underlying cause may be enough to eliminate AFib. However, some patients may need medications to reduce their risk, including blood thinners to prevent blood clots or medications to control the rate at which the heart beats.

If rate control treatments are ineffective, physicians may attempt to regulate a patient’s heart rhythm through medication or medical procedures such as electrical cardioversion or catheter ablation.

The AHA provides the following suggestions for reducing the risk of complications due to atrial fibrillation:

  • Manage hypertension and high cholesterol
  • Exercise regularly
  • Eat a heart-healthy diet, low in saturated and trans fats, cholesterol and sodium
  • Maintain a healthy weight
  • Limit alcohol and caffeine intake
  • Quit smoking

If it’s been too long since you’ve seen your primary care physician for a wellness visit or you suspect you have symptoms of AFib, you can find a physician by visiting TexasHealth.org/provider.

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