Dr Sanjay Gupta...Understanding risk in AFib

[Steve112]

youtu.be/-M2vA4nxzT8(Not working as expected?)

[jennydog]

Thank you for posting this, Steve. Brilliant video. I love the graphics. Dr Gupta's artistic ability is akin to mine!

[BobD Volunteer]

Hmmmm. See also the post on dementia and AF,

[CaroleF in reply to BobD]

Yep. Stroke and dementia - the 2 things I am personally most scared of and way more than that of a bleed. YMMV.

[Hidden]

Thank you for explaining this so well.

[Janshep]

Brilliant Well worth watching xx

[CaroleF]

His manhole analogy helps a lot in understanding the concept of risk in this context - but the poor guy looks absolutely shattered. Hope he manages to get some rest over the weekend!

[dedeottie]

Whilst I understand his concept and explanation of risk, he seems to be completely dispensing with the notion that a fib alone makes us 5 times more likely to have a stroke. Either it does or it doesnt. What about people like me who were , well under 65 , no comorbidities, healthy lifestyle and yet had T.I.A.s or strokes. In my case I had 3 in 18 months then went on anticoagulation and havnt had any more in nearly 5 years. I am not alone , quite a lot of people on the forum have similar tales.

I am not sure at all about this video. My husband is trying to decide whether to start on anticoagulants at 65 th birthday. I am trying to present him with as much info as possible so he can make his mind up. I am trying not to interfere but if he saw this video he would probably decide against as he is not keen anyway.

I would appreciate opinions so he can read all your comments for and against ( i suppose!)

I should add that his dad had vascular dementia and it is his greatest fear. X

[Alan_G in reply to dedeottie]

My understanding is that AFIB itself does not put you at risk of stroke, but as it can cause blood to pool in an appendage to your heart, then the so called comorbidities, if you have them, have a higher chance of causing a stroke. That would still be the case even if you didn't have AFIB. I sometimes think people blame having strokes on AFIB when in fact they may have had a stroke anyway. I know someone like that. He was the last person you'd expect to have a TIA, but he did, and he didn't have AFIB. Just my thoughts.

[moga in reply to dedeottie]

I saw a video which suggested that people with AF and no comorbidities did not have increased risk of strokes. This is why people with CHADS2VASC of 0 are not given anticoagulants despite being in AF. If you had a stroke without comorbidites, then it sounds like you were very unlucky but from the day after your first stroke your CHADS2VASC score would be 2 if you were a man and 3 if you are a woman and therefore you should have been anti coagulated straightaway and your doctor should not have waited for you to have 2 more strokes before starting you on anticoagulation.

[dedeottie in reply to moga]

Yes I agree, i had dreadful treatment when I lived in Lancashire. Thankfully my care has been better here in South Wales despite the quirks of the welsh system and the long waiting lists. X

[Gezp]

Very good analogy to help people understand risk - has many applications in life. However like dedeottie, I’m left a bit puzzled.

I had my first AFib episode about a month ago, lasted around 2 hours, ended up in A&E. I have seen a cardiologist and my CHADS VASc score is 0, so not been put on any anticoagulants - but trying to understand more about what I can do to improve my overall outcomes from this condition.

The video clarified that stroke risk is there for the general population - we all have an increasingly big manhole approaching us regardless of whether we have AFib or not.

The interesting bit is implication that AFib being just a marker and not a risk factor/comorbidity in it’s own right - I think that could confuse people. Surely the annual stroke risk increases in someone who has AFib vs someone who doesn’t - regardless of any other health concerns - and therefore it is a risk factor making that manhole slightly bigger already?

[momist]

Thanks Steve for posting this.

Dr Gupta. Thank you so much for this video on 'risk'. I have understood risk, as I worked in an industry that needed the understanding of risk, but I have never seen such a clearly expressed explanation of it for the lay person, and sadly I also needed your video as a refresher!

I have had a single known event of PAF a week ago, and am still awaiting my referral to cardiology, but now I will understand better the decision to be made about anti-coagulation. Also, I have a clearer picture of the effect of lifestyle and will endeavour to practice some changes.

Ian

P.S. I'm a member of the Lancashire Wildlife Trust, and was visiting Brockholes for a long walk only yesterday!