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Sharp Health News

Understanding AFib and stroke risk

Sept. 19, 2015

Understanding AFib and stroke risk

Atrial fibrillation, or AFib, is a common heart condition that causes your heart to beat irregularly due to defects or damage to the heart's structure. With AFib, electrical signals in the upper heart chamber (atrium) fire incorrectly.

As a result, your heart beats out of rhythm. This abnormal rhythm, or arrhythmia, can result in a rapid heart rate ranging from 100 to 175 beats per minute. A normal heart rate is 60 to 100 beats per minute.

The greatest risk with AFib is stroke. In fact, people with AFib are five times more likely to have a stroke because the irregular heart rhythm can cause clots to form. A clot can then travel to the brain where it might block blood flow, causing a stroke.

To minimize stroke risk, one of the first treatments for AFib is often blood-thinning medication like Coumadin (warfarin). Other medications to control heart rate or rhythm may also be prescribed.

“Medications can help manage symptoms, but they alone can’t cure AFib or eliminate the stroke risk,” explains Dr. Karl Limmer, a cardiothoracic surgeon affiliated with Sharp Memorial Hospital. “Like with all medicines, there’s potential for side effects. With blood thinners, we’re concerned about excessive bleeding. That can limit quality of life for some patients — especially those who want to remain active.”

Newer procedures can help. A doctor called an electrophysiologist can perform a procedure designed to find the source of the irregular heart rhythm and ablate — or destroy — its  pathway through the heart.

Patients who undergo successful ablations have relief of symptoms due to AFib and may have a reduced risk of stroke. They also may be able to stop taking medications to thin the blood and control heart rhythm.

A new two-stage procedure designed to cure AFib is known as mini-maze or hybrid maze. During the first stage, a cardiothoracic surgeon makes three or four tiny incisions in the chest and inserts small tools designed to ablate the arrhythmia’s path around the outside of the heart. The surgeon may also clamp off a portion of the left atrium where blood clots tend to form, reducing the risk of stroke, a technique known as left atrial appendage exclusion.

“This minimally invasive procedure gives patients the benefit of ablation and the ability to reduce stroke risk, all without open surgery,” says Dr. Limmer.

After several weeks, an electrophysiologist performs a second ablation procedure via catheter to block any remaining arrhythmias originating from inside the heart.

”We’re excited to be one of a small number of centers in the country that offer mini-maze to our patients. We’re seeing cure rates of more than 80 percent for patients in early-stage AFib, which compares to about 40 percent for other ablation procedures.”

The longer your heart beats abnormally, the more difficult it is to re-establish a normal rhythm. It is important to seek AFib treatment sooner rather than later.

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