Stroke Risk

[Beta44]

I came across this review published in Stroke Magazine which suggests that stroke risk may be reduced in successfully ablated AF sufferers compared rate or rhythm control by medication.

twitter.com/royalpaplib/sta...

Peter

[Turquoise19]

Thx Peter, I don't have Twitter, any chance you can re post this article ref Just to the paper ?

[Kaz747]

I’m on Twitter. Here’s the link:

ncbi.nlm.nih.gov/pubmed/315...

[Turquoise19 in reply to Kaz747]

Great. Thx, have to register n get the article

[Coco51]

Good to know. Thank you.

[MarkS]

The article doesn't provide any definitive evidence that stroke risk is reduced by successful ablations. It concludes that it may be, which I would agree with. It also says that stroke is more likely to be connected with abnormal atrial substrate caused by atrial dilation and fibrosis. The AF can then further increase risk.

So that implies that you're still at risk of stroke after an ablation. However perhaps slightly less risk due to a reduction in the increasing atrial dilation you would otherwise get with continued AF.

[Beta44 in reply to MarkS]

Well, I came to the conclusion that the authors thought that ablation may well improve outcomes as the evidence to prove otherwise was based essentially on non ablated patients. So no evidence that stroke risk is not reduced, ie. more research needed.

[SRMGrandma Volunteer]

Unfortunately nothing is 100%. People with history of hypertension and atherosclerosis still have stroke risk and women have higher stroke risk than men. The risk does not necessarily correlate with the amount of Afib one has. You can be Afib free and still be at risk of stroke. The standard for calculation is this. mdcalc.com/cha2ds2-vasc-sco...

[KathFrances]

This isn't true! Stroke risk is not 100% gone after AF has been stopped by ablation. See this study done in March 2019 at onlinejacc.org/content/73/9.... It depends on how high or low stroke risk the patient is. This is their conclusion:

Conclusion:

Discontinuing OAT in high-risk patients after CA of AF is associated with a significantly increased risk of thromboembolic events. There is no difference in outcomes between the ON- and OFF-OAT strategy in the low-risk group.

[Beta44 in reply to KathFrances]

That study seems to apply to a cohort of patients who had undergone ablation but without regard to outcome. I presume that it would, therefore, include those who had subsequently reverted to AF and would therefore require anticoagulation anyway.

[lms0006]

Had 3 ablations none worked