Does atrial fibrillation increase the risk of stroke?
Andrew Atiemo, MD, is board-certified in internal medicine and cardiovascular disease and interventional cardiology he is on staff at Banner Estrella Medical Center. He can be reached at (623) 298-5225.
Question: I’m 58 years old and have atrial fibrillation (irregular heart beats). Do I have a higher risk of stroke?
Answer: Atrial fibrillation is a chaotic rhythm where the “atria,” the top chambers of the heart, have a rate of 350-600 discharges per minute. This rhythm is dangerous for two reasons. The atria do not contract in a coordinated fashion, thereby allowing blood to pool inside the heart. This predisposes to clots in the heart which can embolize or travel to the brain causing a stroke. Second, rapid atrial rates may lead to rapid ventricular rates. The “ventricles" are the muscular chambers at the bottom of the heart which pump blood to the lungs and body. Rapid ventricular rates may lead to symptoms such as chest pain or shortness of breath.
Several conditions may lead atrial fibrillation. These include lung disease, thyroid disease, valvular heart disease, alcohol, infection, and coronary disease. One focus of treatment is to identify and treat, if possible, the underlying cause. Other goals of treatment may include medications to control the heart rate and reduce the risk of stroke. In patients who are very symptomatic from atrial fibrillation, your doctor may use medications or electrical cardioversion to restore the normal rhythm.
Certain conditions are associated with an increased risk of stroke. These include age 65 and above, diabetes mellitus, rheumatic valvular disease, history of prior stroke, hypertension, and congestive heart failure. Patients with these predisposing conditions should receive long term anticoagulation medications with warfarin. Warfarin is not recommended for younger patients with no risk factors for stroke.
In summary, if you are 58 years old with atrial fibrillation you may be at significant risk of stroke. Your doctor can evaluate you and determine whether your risk is high enough to warrant anticoagulant therapy.