Atrial Fibrillation and Stroke: What’s the Connection?
By Darius Sholevar, MD, Cardiologist, Virtua Heart Rhythm Specialists
Place your hand over your heart, and you expect the familiar lub-dub, lub-dub beat. But if you feel like your heart is fluttering, racing, or skipping a beat, you may have atrial fibrillation (AFib).
AFib is the most common type of irregular heart rhythm. While episodes of AFib are not harmful by themselves, they greatly increase your risk of having a stroke.
Through medication and minimally invasive procedures, we can restore your rhythm so your heart is beating more efficiently and reduce your likelihood of having a stroke.
The heart’s electrical system sends signals telling the upper chambers (atria) and lower chambers (ventricles) when to squeeze and pump the blood out (contract) and relax. This lets blood move through the heart and out to the body and lungs.
AFib causes the atria to quiver or “fibrillate” instead of pump in an orderly fashion. The disorganized or chaotic electrical signal spreads to the ventricles and causes them to contract irregularly. As the atria and ventricles are no longer in sync, the amount of blood pumped out to the body will vary with each heartbeat.
Because the heart is contracting too quickly or unevenly, blood may remain in the atrium and pool. Blood that pools and moves slowly tends to clot. If a clot forms in your heart and then breaks off, it can block an artery and restrict blood flow to the brain, causing a stroke.
Preventing a Stroke
In people with AFib, blood pools and clots in a pouch within the left atrium called the left atrial appendage. To prevent clotting, your health care provider may prescribe a blood thinner.
If you can’t take a blood thinner because of a risk for bleeding, you may be a good candidate for the Watchman device. To implant the Watchman, the electrophysiologist (a heart rhythm specialist) threads a catheter through a vein in your leg to the heart. A tiny hole made in the wall between the atria allows the catheter to reach the left atrial appendage.
The Watchman, a small, mesh parachute a little larger than a half dollar, is placed at the entrance to the appendage, preventing any clots from escaping and causing a stroke. A daily aspirin helps prevent future clots from forming.
Back on the Beat
To restore your heart rhythm and relieve any symptoms you may be having, such as difficulty breathing, lightheadedness, or fatigue, your provider may prescribe an antiarrhythmic medication, such as a beta blocker.
If necessary, your electrophysiologist will use a special catheter to deliver radiofrequency energy to the area of the heart causing the abnormal rhythm.
Whether you were diagnosed recently with AFib or have been living with it for years, there are treatment options that can reduce your risk for having a stroke.
You may not be able to keep a beat, but your heart should.
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Updated January 13, 2023