Does Having A-Fib Increase Your Stroke Risk?
By Thomas Galski, DO, Cardiologist—Virtua Cardiology Group
Atrial fibrillation, or a-fib for short, is the most common type of heart arrhythmia, or irregular heartbeat. Although a-fib by itself is rarely life threatening, it’s a serious condition.
An increased risk of stroke is one of the most dangerous complications of a-fib.
In fact, the National Stroke Association estimates that about 15 percent of people who have strokes also have a-fib.
If you were diagnosed recently with a-fib or if you’ve been living with it for a while, there are treatment options that can reduce your risk for having a stroke.
What is a-fib?
A-fib is a type of irregular heartbeat caused by chaotic electrical activity in your heart. These abnormal electrical signals cause the top chambers of your heart, called the atria, to quiver instead of beating normally. As a result, the atria are unable to move blood effectively into the lower chambers of your heart, called the ventricles.
Many people who have a-fib experience heart palpitations, or feel like their heart is racing, fluttering or flip-flopping. Other symptoms include:
- Chest pain
- Difficulty breathing
- Difficulty exercising
- Lightheadedness or dizziness
- Weakness or fatigue
A-fib doesn’t always cause noticeable symptoms. Often, it’s diagnosed during a routine exam. People who have a history of cardiovascular disease, high blood pressure, diabetes and sleep apnea are more likely to develop a-fib. Drinking excessive amounts of alcohol, smoking and intense athletic training also can raise your risk.
How does a-fib increase my stroke risk?
The American Heart Association/American Stroke Association estimates that people with a-fib are 5 times more likely to have a stroke than people who don’t have a-fib. That’s because a-fib causes problems with the atria’s ability to pump blood effectively.
When the atria are unable to pump properly, blood can pool inside the left atrium. It’s especially likely to pool in the left atrial appendage (LAA), which is a small extension of the left atrium that’s about the size of your thumb.
This pooling of blood can cause a blood clot to form. If a blood clot forms and gets pumped out of your heart, it can block an artery and restrict blood flow to your brain, causing a stroke. During a stroke, brain cells can become damaged or die due to a lack of oxygen-rich blood.
Researchers estimate that 90 percent of strokes in people with a-fib are caused by blood clots that form in the LAA.
How does treating a-fib lower my stroke risk?
A-fib usually can’t be cured completely, but proper treatment can reduce symptoms and lower your risk of stroke and other complications. Your treatment for a-fib will have one or more of the following goals:
- Restoring your normal heart rhythm
- Controlling your heart rate
- Preventing blood clots
- Lowering your stroke risk
Your doctor will recommend a treatment plan based on your health history, the severity of your symptoms and whether your symptoms are causing other problems, such as heart failure. Generally, the more severe your symptoms, the more aggressive the treatment strategy. A-fib treatments include:Medications
- Anti-arrhythmic medications help restore your normal heart rhythm.
- Blood-thinning medications reduce your risk of blood clots and stroke.
- Other drugs help control your heart rate.
If you’re taking medication to treat a-fib, you should talk to your doctor before making any changes or stopping your medications. Even if you’re not having symptoms of a-fib, you may still need medications to lower your stroke risk.
Cardioversion is a non-surgical procedure that delivers a shock to restore your normal heart rhythm using paddles or patches attached to the outside of your chest.
Catheter ablation involves threading a special catheter through the blood vessels to your heart. After the catheter is in place, it delivers radiofrequency or cryo energy that creates scar tissue to block the abnormal electrical activity that’s causing your heart to beat abnormally. Another procedure called hybrid ablation uses surgical and catheter-based techniques to block abnormal electrical signals.
A-fib can be treated with a procedure called maze surgery. During maze surgery, the surgeon makes tiny incisions in the atria to create scar tissue. This scar tissue can’t conduct the abnormal electrical signals that cause the heart to beat abnormally. This allows the heart to return to normal rhythm. Maze surgery can be performed using minimally invasive techniques or as open surgery.
Treatment to restore your normal heart rhythm lowers the chance that a blood clot can form in the heart. Another treatment called a left atrial appendage closure helps lower your stroke risk using a special device to seal off the LAA—where blood clots commonly form—from the rest of your heart.
If you have a-fib, getting the right treatment can lower your risk of having a stroke.
To find a Virtua cardiologist near you, call 1-888-847-8823.
Updated August 28, 2018