Atrial Fibrillation, or afib, is a common cause of strokes, and you may not even realize you have it. It is a disorder of the heart that causes the upper chambers to quiver like jelly. When they quiver, they cannot pump blood as effectively, and this can lead to clots. When the lower chambers of the heart, the ventricles, fibrillate, the person goes into cardiac arrest. The upper chambers, or atria, are not as crucial, but when they do not pump properly, heart problems and stroke can follow. You may have been told that afib is the cause of your stroke, so it is important to know as much about it as possible.
The Connection between Atrial Fibrillation and Stroke
You may wonder how a problem in your heart can lead to a clot in your brain, and you would be right in doing so. When the atria are unable to pump, the blood pools in the chamber, never getting fully ejected. As you may know, whenever blood stands still, it starts to form clots, and these can build up in the atria without your knowledge. At some point, the clot is ejected from the chamber. Either it stops fibrillating momentarily, or the clot is simply pushed through with the rest of the blood.
Once this clot is ejected into the heart, it can go anywhere. In fact, one place it can go is the coronary arteries and cause a heart attack. Another option is for the clot to travel up through the carotid arteries and into the brain, causing a stroke. Either option is a possibility, and neither one is healthy for a patient. Sometimes the clots caused by afib are smaller ones and can lead to less severe strokes. However, long untreated afib can form quite a large clot, and this can lead to severe impairment. Fortunately, afib is treatable.
Most people who have afib don’t realize it, and that’s why a stroke can come seemingly out of nowhere. If you were to take your pulse or have your doctor listen to your heart, you would notice that the beats are out of sync. Afib is an arrhythmia, which means the heart doesn’t beat on the rhythm it is supposed to. At lower rates, it is easy to miss the extra beats that afib sometimes presents as. It is only when you are examined by a doctor that afib can be found.
In some cases, the afib may be rapid. You would feel palpitations in your chest, chest pain, and faintness. This is relatively rare, though, and the slower beats are much more common. With rapid afib, you will experience some severe heart problems, shortness of breath, and other problems that will compel you to visit a doctor. The real problem is the afib that isn’t detectable by symptoms. It is this form of afib that tends to lead to strokes, but even if you have no symptoms, afib needs to be treated.
There are two steps to treating afib. One is anticoagulation and one is rate control. When you have a stroke, you are going to need anticoagulation therapy, anyway, regardless of the reason you had the stroke. This means that you will be placed on heparin in the hospital and then slowly introduced to Coumadin or warfarin. The medication takes a little while to become therapeutic, and you will need to get regular blood tests to ensure that it stays in the safe range. Failure to check you warfarin level could mean that another clot forms and leads to a secondary stroke.
The second prong of afib treatment is rate control. Medications, such as Cardizem and Amiodarone, can help to control rapid afib and sometimes convert the rhythm to normal. In some cases, your cardiologist may want to do everything possible to convert the rhythm, and this means that a cardioversion may be attempted. Under sedation, the heart is shocked to attempt to restore normal function. It isn’t always successful. Another way to treat this rhythm is to have an ablation done. This is usually conducted through a cardiac catheterization, and it centers on cauterizing the cells in the heart that are causing the bad rhythm. This is usually an outpatient or short stay procedure, using only small access through the artery that runs in the groin.