August 16, 2017

Atrial Fibrosis, Not Afib Type, Linked to Atrial Fibrillation Strokes

Researchers at the Comprehensive Arrhythmia Research and Management Center (CARMA) in Utah have been studying the relationship between atrial fibrillation, atrial fibrosis, and catheter ablation outcomes for many years. Now, they’ve applied their knowledge of quantifying atrial fibrosis to stroke risk assessment and found that the amount of atrial fibrosis, not type of afib, is independently associated with stroke.

Learn more: New Research Yields Insight into Stroke Mechanism for Atrial Fibrillation Patients

Comments

  1. My wife, after waiting a week, was diagnosed with A-Fib while in Ontario last September. She received a cardioversion and was back in normal sinus rhythm until she again experienced A-Fib two days before returning to the States in November (she didn’t want to take the prescribed meds but did take an adult aspirin daily).

    Upon returning to the States she immediately saw her cardiologist who set her up for another cardioversion two days later. At his insistence she took the meds, Propafenone HCL and Bisoprolol Furmarate, and continued the aspirin. The doctor didn’t want her on warfarin. When she went for the cardioversion, the ECG showed that she was back in normal sinus rhythm. The attending cardiologist (same group, different doctor) sent her home. She suffered a massive stroke four days later that proved fatal within days..

    My question: should a TEE have been performed to check for clotting before sending her home (Unfortunately neither of us thought to ask). Her cardiologist said that the TEE results from Canada showed a clear atrium and therefore there was no reason to believe clotting had taken place. It seems to me the cardiologist who was to perform the cardioversion was negligent and her MD was covering for him. I need peace of mind on this.

    • W. Hala,

      I am so sorry. My heart goes out to you for the loss of your wife.

      It seems that most of the time doctors have those with afib take warfarin for several weeks, or they do a TEE, before cardioversion. However, no cardioversion was actually done on your wife. If they had done a TEE, they might have seen the clot, but that doesn’t mean they could have done anything about it. It may have been building over a couple of months since the first episode.

      So did they prescribe warfarin for her in Canada upon her first episode? And was there a reason the cardiologist back home didn’t want her on warfarin?

      I don’t know her age, but being female gave her a greater stroke risk. You can learn here about the CHADS2 and CHA2DS2-VASc scoring systems that are used to determine whether someone should be on warfarin or not: New Stroke Risk Factors for Those with Atrial Fibrillation (AF): Female Gender, Heart Disease, and Age

      Again, I’m really sorry.

      Mellanie

  2. I have A-fib from time to time. Short episodes of seconds to minutes; only twice in 30 years more than 20 minutes. Years ago a cardiologist told me that the risk of a stroke was with A-fib cases of more sustained periods than I experience, is that correct?

    • Darryl,

      There used to be a belief that you had to be in afib for 24-48 hours for a clot to form, but that is being disputed by some recent research. And we also know that many people have both symptomatic afib, which you would feel, and asymptomatic afib, which you wouldn’t feel, so you could have afib at times and not know about it.

      Your CHADS2 score (or the more sophisticated CHA2DS2-VASc score) should indicate whether or not you should consider blood thinners. We’ve written extensively about these scores – you can find out more at http://www.stopafib.org/newsitem.cfm/NEWSID/220 – that should take about 5-7 minutes to go through and fully assess your potential risk.

      Mellanie

      Mellanie

  3. went to my gp years ago about ppalputations and was told i drank too much coffee.Didnt think too much about it till i saw a program on telly about a medical condition so went back to gp who sent me for an ecg and was having an episode while on the machine i was sent to A andE and was diagnosed with A fib was put on beta blockers and disgarged..3 days later i had a stroke,which as left me weaker don my ,left side and was taken off the beta blockers at that time and put on blood thinners since then i have exsperiansed a lot of Afib episodes i am going to see my gp at the end of march

    • Jenny,

      I’m so sorry about your stroke. I am surprised they didn’t put you on Coumadin or warfarin at A&E. So why did they take you off of beta blockers when they put you on Coumadin? Those are for 2 different things (Coumadin for strokes and beta blocker for slowing the heart rate, and sometimes converting you), and it sounds like you need both. Can you see a specialist (an electrophysiologist) sooner?

      Mellanie

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