Atrial Fibrillation and Stroke Prevention

Featuring Dr. Katia Dyrda, MD, BSc., FRCP, Ing, Cardiologist – Cardiologist - Electrophysiologist

Duration: 3 minutes, 25 seconds

Atrial fibrillation is an arrhythmia that is defined by a rapid and irregular heart rhythm in the upper chambers of the heart, called the atria. At times the lower chambers of the heart, the ventricles, may follow slowly or they may follow faster. So you may be told that you have slow atrial fibrillation or rapid atrial fibrillation.

Atrial fibrillation may arise due to underlying medical conditions, but it can also happen if you have a completely normal heart. Some other conditions that you have may predispose you to it, such as hypertension, sleep apnea, and a long list of other causes.

Atrial fibrillation may be linked to a higher stroke risk, because when your atria are beating very fast, they can not empty all the blood they contain in one heartbeat. When that occurs, the blood pools and that can cause a small clot that can travel to your brain. If that clot blocks an artery that feeds your brain, that leads to what we call a stroke. A stroke may manifest itself with loss of movement, paralysis, loss of speech, balance, vision – those are common symptoms.

The severity of the symptoms you may have linked to your atrial fibrillation are not in any way related to your risk of stroke. We use the acronym CHADS-65 to determine whether or not you should be on a medication called a blood thinner to reduce your stroke risk. This acronym stands for congestive heart failure, hypertension, age as of 65, diabetes or stroke.

If you have any one of those risk factors, you should be on a blood thinner. There are different agents to thin your blood. The older agent on the market is called Warfarin, and this medication requires multiple bloodwork and adjustments. Nowadays we have four other agents that are available, and these agents are a little bit easier to take as they don’t require as frequent bloodwork or adjustments.

It is very important to take your blood thinner as it is prescribed in order to get the full protection of it. This is called compliance. If you omit a dose, if you forget a dose, then you may not have the same protection that we hope for you to have from that medication. It is very important in case of bleeding that you consult with your doctor or your pharmacist. In some cases the medication needs to be stopped, but in other cases it might be safe or even safer to continue it.

If you happen to forget a dose of your medication, or lose your medication or run out, please contact your pharmacist to get advice on how to restart your medication. If you do not have any of the CHADS-65 risk factors but have coronary artery disease, which means blockages in the arteries that feed your heart, or blockages in other arteries, your physicians will likely prescribe an anti-platelet, such as aspirin.

If you do not have any of those risk factors, there are ongoing studies to understand better how to protect you. One such study, which is driven out of the Montreal Heart Institute, is called a BRAIN-AF study. Your physician may speak to you about it.

If you have any further questions about your atrial fibrillation, please talk to your physician, your atrial fibrillation clinic or your pharmacist.

Presenter: Dr. Katia Dyrda, Electrophysiologist, Montreal, QC

Local Practitioners: Electrophysiologist