Atrial fibrillation and stroke


Causes of atrial fibrillation include heart-related problems such as high blood pressure, coronary artery disease, heart failure, heart valve disease and heart surgery.Causes of atrial fibrillation include heart-related problems such as high blood pressure, coronary artery disease, heart failure, heart valve disease and heart surgery.

ATRIAL fibrillation, known as AFib, is a common heart rhythm disorder that can have a significant impact on an individual's health and quality of life.

According to cardiologist Dr Surinder Kaur Khelae at Institut Jantung Negara (IJN), this type of irregular heartbeat increases your risk of stroke by five times.

“In cases of AFib, the atria contract chaotically, and because it is not pumping blood properly, blood pools get stuck inside the heart.

This leads to the possible formation of blood clots which could be pumped to the brain and interrupt the brain’s blood flow, resulting in a stroke.”

The first type of AFib is paroxysmal AFib which occurs occasionally and then stops.

An episode may last for seconds, minutes, hours or days before the heart returns to its normal rhythm.

People with this type of AFib often have more symptoms than others.

As the heart goes in and out of AFib, the pulse rate may change from slow to fast and back again in short periods.

The other type is persistent AFib that does not stop by itself. Various treatments may help return the heart to its normal rhythm. Talk to your doctor about your treatment options for persistent AFib.

Causes of AFib are heart-related problems such as high blood pressure, coronary artery disease, heart failure, heart valve disease, and heart surgery. Other health problems such as sleep apnea, thyroid disease, lung disease or lung cancer, drinking too much alcohol, being seriously ill, or having an infection are other potential causes.

Dr Surinder shares that AFib is a common heart rhythm disorder that increases your risk of stroke by five times.Dr Surinder shares that AFib is a common heart rhythm disorder that increases your risk of stroke by five times.

Dr Surinder shares the various symptoms of AFib include an irregular heartbeat (fast, slow, or both), heart palpitations (fast, slow, or both), feeling overly tired or having low energy, shortness of breath, chest pain, pressure, tightness or discomfort, dizziness, lightheadedness or fainting. Some patients, however, may not have any symptoms at all.

Diagnosing AFib

When suspecting AFib, doctors will start by asking about symptoms and checking for an irregular heartbeat using a stethoscope. They may perform tests to confirm the diagnosis and determine its cause and treatment options, including:

>Electrocardiogram (ECG/EKG): A simple, painless test for diagnosing Afib

>Holter or Event Monitor

>Echocardiogram (Echo): Transthoracic or Transesophageal (TTE/TEE)

>Cardiac computerised tomography (CT)

>Magnetic resonance imaging (MRI)

>Digital wearables (e.g., Apple Watch, etc.)

Treatment for AFib

Once diagnosed with AFib, you and your doctor will create a personalised treatment plan, possibly involving a heart specialist like a cardiologist or electrophysiologist. Treatment options may include medication, procedures, and lifestyle changes.

Dr Surinder notes that every patient is different, but there are four main strategies for managing AFib. “You may hear your doctor call these the Four Pillars of AFib Care. Depending on your needs, your doctors may recommend one or more of these strategies.”

Pillar 1: Rate control (managing or preventing your heart from beating too fast)

Lowering the heart rate in AFib treatment includes options like medications, as well as implanted pacemakers that monitor heart rhythm and deliver controlled electrical pulses at a slow rate.

Pillar 2: Rhythm control (returning to and maintaining a normal heart rhythm)

People with AFib may experience irregular heartbeats, known as palpitations, which can be addressed through:

>Medications: Antiarrhythmics can help maintain a normal rhythm.

>Catheter Ablation: A procedure involving a catheter inserted through a groin blood vessel to create a "scar" in the heart tissue, preventing abnormal signals.

>Electrical Cardioversion: This non-medicinal option involves administering an electrical shock to the chest under mild anaesthesia, aiming to reset the heart to a normal rhythm.

Pillar 3: Stroke prevention (preventing the formation of blood clots)

Blood thinners or anticoagulants may be prescribed to prevent the formation of blood clots that can lead to a stroke.

Pillar 4: Risk factor management (focusing on lifestyle choices and modifications)

>Eating a healthy diet and maintaining a healthy weight

>Exercising moderately and regularly (note: Extreme exercise in certain circumstances may increase your risk of AFib. Talk to your doctor before you start a new exercise routine.)

>Avoiding or limiting the use of tobacco, recreational drugs, caffeine and alcohol

>Managing your diabetes

>Controlling your blood pressure and cholesterol

>Treating sleep apnea (if present)

>Avoiding unnecessary stress

>Having regular physical exams

Dr Surinder urges individuals with signs of AFib to consult a cardiologist as people with AFib are not only five times more likely to have a stroke but experience more severe strokes.

For more information, contact 03-2617 8217.

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