Does Afib cause Strokes or not? - Atrial Fibrillati...

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Does Afib cause Strokes or not?

BigArnie profile image
131 Replies

I watched a video by Dr Sanjay Gupta in which he theorised that it does not and then quoted various research to the contrary and pointed out that anti-coagulants are prescribed only if you have the standard risk factors for stroke, independent of your Afib. Is this a widely held view? Thanks for any inputs.

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131 Replies
Finvola profile image
Finvola

Dr Guapta talks about 'the company which AF keeps' causing strokes - the points laid out in the CHADsVASC scoring system. Each has the potential to cause a stroke - eg hypertension.

Add to this the fact that AF can cause the blood to pool in the left atrial appendage causing a clot which can be pumped out when NSR resumes - and you have another factor which can cause a stroke.

In addition, AF increases the chance of a stroke by a factor of 5 - not particularly relevant if your CHADs score is 0 but highly significant with a score of 3 or 4.

I think the mix of circumstances which can cause a stroke in AF patients is complicated and I also wonder if there is a genetic factor swirling around in there too.

BigArnie profile image
BigArnie in reply to Finvola

Yes it is is complicated for sure. So I am correct that you would be given anticoagulants if you have a sufficient Chads score, irrespective of your Afib status. And is the multiple of 5 really correct? Because, if so, it would suggest that Afib should be taken into account when prescribing anticoagulant medication, whereas in fact it is not?

Finvola profile image
Finvola in reply to BigArnie

That's my understanding too Arnie - I haven't had an AF episode that I am aware of in 7 years but with a CHADs of 2, recently increased to 3 because of age, I'm strongly advised to be anticoagulated.

The fact that AF isn't taken into account for anticoagulation confused me at the beginning but this is where the 'company which AF keeps' becomes relevant. Everything I have read indicates that AF increases the stroke risk by a factor of 5.

Elli86 profile image
Elli86 in reply to Finvola

Have you had an ablation fin? If not what would you put down to your lack of episodes over the past 7 years?

Finvola profile image
Finvola in reply to Elli86

No ablation but I have been taking 200mg Flecainide and a beta blocker for 7 years and so far, so good. My cardiologist feels that I am lucky that it has stopped the episodes - so far.

Elli86 profile image
Elli86 in reply to Finvola

If you haven’t had any episodes for 7 years has it never been discussed to try to wean off and see what happens?

Finvola profile image
Finvola in reply to Elli86

I twice tried to reduce from 200 mg to 100mg daily - first time fairly quickly and second time at a snail's pace, going down in 25mg steps. I had almost constant PVC's at both attempts - rotating every 2nd, 3rd and 7th beats endlessly. My cardiologist advised me to stay on 200mg as it wasn't worth putting up with the misery which showed no signs of abating. Now things are so settled that I don't want to rock the boat.

But, I agree with you, only I'm not brave enough!

Elli86 profile image
Elli86 in reply to Finvola

No I get that. Your heart is probably so reliant on the drugs now that it would be really difficult to come off. If your quality of life is good and you don’t get any episodes then I get why you wouldn’t want to rock the boat. I personally would want to come off them and see if my heart had reverted permanently but that’s easy for me to say. I’m only 34 so I don’t want to spend my life taking drugs but if I was a lot older and comfertable then that might be a different story

Finvola profile image
Finvola in reply to Elli86

Agree totally - Elli. At your age I would be very keen indeed to try to be drug free. I'm 76 and have great quality of life, considering how debilitating my Af episodes were. I continue with healthy living, stress minimizing and trying to be as positive as present conditions allow any of us.

Dslokes profile image
Dslokes in reply to Elli86

At your age I would go ablation. I did at 47, and was told the earlier you do it, the better the chance of success. God-willing, my heart has been as healthy as someone in their 20s for 2+ years now.

Elli86 profile image
Elli86 in reply to Dslokes

Glad to hear it dslokes 👍 looks like that’s the way I’m leaning to be honest. Was supposed to be going for a consultation regarding ablation next month at st barts but they’ve cancelled on me and moved it too June now 😩😩 not happy!

Dodie117 profile image
Dodie117 in reply to Elli86

I had my one and only ablation in 2013 aged 63 and free of af since then. No meds except anticoagulant. Currently looks like it might be returning as have had a few episodes. Highly recommend ablation and if recommended will have another. Good luck 🍀

Elli86 profile image
Elli86 in reply to Dodie117

Well you’ve had a nice run of 8 years Lallym if it does return. Hopefully not though 🤞if it does you’ll be having another ablation I’m assuming?

Dodie117 profile image
Dodie117 in reply to Elli86

Absolutely

7164 profile image
7164 in reply to Dodie117

LallymWhy do you think it is returning please

Rod

Dodie117 profile image
Dodie117 in reply to 7164

Rod, I am having the odd AF episode and a lot of ectopics/trigeminy. Doctor keeping an eye and I am monitoring with Kardia.

MissTia123 profile image
MissTia123 in reply to Elli86

Im not much older than you and have been able to reduce my dose a little but if I go to low the AF returns, every “body” is different and you have to go with what is comfortable and safe.

Elli86 profile image
Elli86 in reply to MissTia123

Have you had an ablation tia? What meds are you currently on?

LaceyLady profile image
LaceyLady in reply to Elli86

I thought some get withdrawal symptoms trying to come off Flecainide too fast.

Elli86 profile image
Elli86 in reply to LaceyLady

I couldn’t wait to get off flec. I came straight off and went straight on bisop next day and felt better almost straight away

LaceyLady profile image
LaceyLady in reply to Elli86

I’m normally on 50mg x 2 and bisoprolol 1.25mg. When I have an episode it was suggested to increase the Flecainide, which I did last Sunday, didn’t stop it. I’m reluctant to stay on higher dose in case I get too used to it and have to keep increasing, so I will reduce back in a day now I’m out of it.

Elli86 profile image
Elli86 in reply to LaceyLady

That’s what I was taking. 50mg twice a day. Horrible. Couldn’t function at all on it. Like I say though came off after 8/10 weeks and straight on bisop and saw pretty much instant improvement. Couple of days and I felt great in comparison

LaceyLady profile image
LaceyLady in reply to Elli86

My consultant said Friday, that I have to have some bisoprolol with the Flecainide, why I don’t know. Don’t want any of these drugs. I dream all night d heavy! I have difficulty in my left shoulder which I think is the drugs, left knee partially replaced 11/19 has odd soreness/aches, I think that’s the drug too! I don’t w know why I was put on this Amount of drugs instead of a pill in the pocket 🤷🏼‍♀️

Elli86 profile image
Elli86 in reply to LaceyLady

Was pip working for you then? Doesn’t make sense to take you off if it was. I wouldn’t be surprised if the symptoms you listed are due to the drugs. As I said before I felt dead on flec. Everything seemed like it was failing. My heart felt like it was going to stop, EXTREME fatigue to a level I’ve never experienced before, whole body ached all over, terrible brain fog, depression the list goes on. Couldn’t wait to get off. Can’t wait to get off drugs in general to be honest. Absolutely despise taking meds

LaceyLady profile image
LaceyLady in reply to Elli86

No, wasn’t even offered a pill in the pocket option. I’m sure they give me aches and weakness, this is why I like to keep to the minimum drug dose.

Elli86 profile image
Elli86 in reply to LaceyLady

Yeah the lower the dose the better in my view 👍

secondtry profile image
secondtry in reply to Finvola

Hi Finvola, with similar circumstances and thoughts ('I don't want to rock the boat'), I just wondered whether you had your Covid jab and if so any AF issues? I have postponed mine as have had no AF or flu to speak of for 7 yrs and at present am leaning towards Pfizer if we get an option in the future.

Finvola profile image
Finvola in reply to secondtry

Hi secondtry - Yes, I went like a rocket for my first jab in early February and, although I was woozy for some days, my heart behaved impeccably - I had AZ. My second jab is due in 2 weeks' time and it will be a great relief to have some degree of protection from the virus.

secondtry profile image
secondtry in reply to Finvola

Thanks very gutsy and great news. Please post second jab news, always reassuring to hear no problems or be forewarned if there are.

Finvola profile image
Finvola in reply to secondtry

Will do.

oscar3993 profile image
oscar3993 in reply to secondtry

Hi..I too have had my first dose (Phizer) no problems except for sore arm at site for a day !

Jetcat profile image
Jetcat in reply to Finvola

I hated the PVC s. it started getting me really down. I couldn’t concentrate at all? trying do my job at work and just being so aware of the missed beats and a thump here and there.😡. I often wondered what was worse my Afib or the PVCs.?

betsea profile image
betsea in reply to Finvola

My Dr. Started me on 200mg of Flecanide per day. I could hardly function so I weaned myself down to 100mg per day. It's been very successful for over a year now. When I tried to lower my dose to 50mg per day. I started getting skipped beats again then some short lived Afib so I'm back on 100mg daily. I also stopped my Eliquis as I was unable to take any anti-inflammatories and I need Advil daily for pain. For me it came down to quality of life.

karrog profile image
karrog in reply to betsea

When you say 50mg, I'm assuming that's bid?

Singwell profile image
Singwell in reply to Finvola

Envious!

cuore profile image
cuore in reply to Finvola

Seven years is a long time. Does that mean if you stopped the pills the arrhythmia would come back?

Finvola profile image
Finvola in reply to cuore

That would be my assumption, cuore.

Nerja2012 profile image
Nerja2012 in reply to Finvola

I'm the same as you Finvola, also score 3 now because of being Female and 76, no other reason as I don't have any comorbities, 1 episode in 15 months, I also watched the video and it left me completely confused.

Finvola profile image
Finvola in reply to Nerja2012

Me too but when I was told with a score of 2 to start Apixaban, I went for it. I don't think too much about the detail of it, just am glad to have some protection against stroke.

Singwell profile image
Singwell in reply to Nerja2012

I think Dr Gupta was having an 'academic' moment in that he was referencing scientific research papers that were looking into causality. In medical science causality is different from 'associated with', at least that's how I understand it. In practice, if there's a statistical likelihood of stroke via your CHAD VAS score then you'll be asked to take anticoagulants. It's all about risk factors.

MissTia123 profile image
MissTia123 in reply to Finvola

Whats a chad?

Finvola profile image
Finvola in reply to MissTia123

MissTia - It's a method of scoring risk of stroke and is used to generate a number which can help to determine if anticoagulation should be recommended to AF patients. You can work out your score here:

mdcalc.com/cha2ds2-vasc-sco...

Bagrat profile image
Bagrat in reply to Finvola

I haven't had an episode since 2013. Managed to reduce Flecainidè to 50mg bd a few years back ( no other interventions). at soon to be 77 I too am reluctant to rock the boat so carry on with this and apixaban.Have some grim days but that is due to my vivid imagination plus health anxiety I suspect. Sailed through radiotherapy for breast ca just over a year ago, no reaction to astrazeneca jab but did have a weird 5 mins of totally erratic pulse 2 weeks ago, diff from usual ectopics. Deep breathing sent it on its way.

Finvola profile image
Finvola in reply to Bagrat

Good to hear Bagrat. I remembered that you reduced your Flec around the time I tried to. Long may things remain stable for us both. xx

Ivan_the_Terrible profile image
Ivan_the_Terrible in reply to Finvola

The mechanism you suggest for AFib causing strokes does not apply in case of persistent AFib. This makes me wonder whether there has been any study on the relationship between different types of AFib and stroke. I have persistent AFib and am 66 with no other comorbidities. I don't currently take anticoagulants but try to consume foods with blood thinning properties.

Finvola profile image
Finvola in reply to Ivan_the_Terrible

I don't recall seeing any reports of research into AF types and stroke risks. I have no medical training but if blood can pool in the LA appendage might a clot still be released even if there is no return to NSR? Massive area with so much to learn and know . . .

7164 profile image
7164 in reply to Ivan_the_Terrible

IvanWhat does persistent feel like?

Ivan_the_Terrible profile image
Ivan_the_Terrible in reply to 7164

If I take beta blockers or drink Hawthorn tea I don't really feel anything in my heart, I iust get tired quite often.

7164 profile image
7164 in reply to Ivan_the_Terrible

IvanDid you have symptomatic paf?

I am in a strange place where my cryo has not failed but I worry that it will. Then another ablation or leave it until persistent transforms the paf as most people say it is much easier to live with and the horrible anxiety will leave me??

Rod

Ivan_the_Terrible profile image
Ivan_the_Terrible in reply to 7164

Rod, I was only ever diagnosed with persistent. Am I lucky?

7164 profile image
7164 in reply to Ivan_the_Terrible

IvanNobody in this club is lucky😊

Were you symptomatic?

Paf is usual before persistent?

Did you never feel a change from sometimes to always?

Rod

Ivan_the_Terrible profile image
Ivan_the_Terrible in reply to 7164

All I felt in my early 60s was that I felt tired more frequently than I thought I should. A doctor in a Russian sanatorium took a heart reading and said I should be checked but I ignored this until I felt my heart pounding after drinking a can of Red Bull. I haven't touched the stuff since. Very occasionally I feel a bit of pounding. It was diagnosed as persistent. I think I'm one of those on whom it creeps up more or less silently.

BobD profile image
BobDVolunteer

What Dr Gupta actually says is that it is not so much the AF that causes the stroke but the company it keeps.

To hopefully clarify, a young fit person with no comorbidities will have a CHADSVASC score of zero and not need anti-coagulants. This is precisely why Prof Lip created CHADS2VASC2. As more and more comorbidities such as age , previous heart disease etc are added the need for anti-coagulation increases. So without AF there is no or little risk apparently but so far there is no risk assemement tool without AF. The two therefore are linked and shuld not be separated.

BigArnie profile image
BigArnie in reply to BobD

Thanks Bob. Not sure I quite get the thrust of your argument here. In particular, is it really the case that there is little or no risk of a stroke unless Afib is present? In some ways I am leaning to the view that the “company it keeps” concept merely means that quite often someone who presents to a cardiologist with Afib will also have a “high” Chads score, but that is not the same as saying that Afib is a stroke risk in itself.

BobD profile image
BobDVolunteer in reply to BigArnie

The reality is that stroke risk in the general population is never assessed. Sure if you have high blood pressure or high cholesterol efforts will be made to change that but again you have presented with a condition which pre disposes to stroke.

The world is full of people with AF who have been told their stroke risk is negligible and they do not need these drugs just a few days before their stroke so I am quite happy to take my Anticoags regardless of any debate.

The underlying fact is that AF increases stroke risk by 5 times . The problem is knowing what to multiply by five.

BigArnie profile image
BigArnie in reply to BobD

Hi Bob and Finvola, regarding “The underlying fact is that AF increases stroke risk by 5 times” do either of you happen to have a reference for this multiple? Thanks.

BobD profile image
BobDVolunteer in reply to BigArnie

Just about anything ever written about AF shows this figure. and always has done.

Finvola profile image
Finvola in reply to BigArnie

Here's one Arnie - lots on google but this one looked 'heavy' enough to have some clout:

ncbi.nlm.nih.gov/pmc/articl...

BigArnie profile image
BigArnie in reply to Finvola

Thank you - that is pitched just right for me and very informative!

secondtry profile image
secondtry in reply to BigArnie

Thanks first to Finvola for the link reminding us of the 'Framlingham study' which I now recall has been the main source for the often quoted 5 times as likely to get a stroke with AF. I see the Abstract of that study actually says '..and a near fivefold excess when atrial fibrillation was present.' I hope this backs my position which is to postpone, at 67yo active with no comorbidities, taking Anti-Coags as I do not have AF regularly 'present', last 30 min episode was 2 years ago.

Moneybox profile image
Moneybox in reply to BobD

Hi, im 43 and I got diagnosed with AF at 38. After trying a couple of different drugs, my AF settled with Flecainide and Tildiem. Just before my 40th birthday I lost my mother and suffered a mini stroke (TIA) The doctors said due to the stress and having AF I was automatically put on Apixaban. I believe if I didn’t have AF I probably wouldn’t have suffered with my mini stroke.

Peony4575 profile image
Peony4575 in reply to BigArnie

I have mentioned this before. My friends husband a fit 50 year old had a stroke and crashed into a tree . He was unaware he had AF. I don’t know if it was pAF or persistent and he doesn’t either . He’s fine . Recovered from the stroke and back at work in a matter of weeks . The tree had longer term disability ! The fibrillating atria act like a butter churn . I tell this tale as someone who doesn’t take ACs. But if I had frequent episodes I would

Nerja2012 profile image
Nerja2012 in reply to BobD

But if a patient fits the same criteria Bob as a younger person eg no comorbities but is 76 and female why does that put me in the high risk bracket just because of gender and age. I aso watched the video.

BobD profile image
BobDVolunteer in reply to Nerja2012

Because that is what statistics show.

Peony4575 profile image
Peony4575 in reply to Nerja2012

They are moving away from giving you a point for being female according to The AF Cure book. Takes decades for these things to percolate down. Effecting change is a bit like turning a very large tanker in a canal !

Nerja2012 profile image
Nerja2012 in reply to Peony4575

Peony, so if they take away 1 point for being female ill still score 2 because I'm 76 , shame I don't get browny points for having no comorbities and infrequent episodes. Carnt make any life style changes as I'm very fit and healthy. Chads score ! It doesn't include people like me they just assume all people my age will have comorbities so I'm penalised for being older.

Peony4575 profile image
Peony4575 in reply to Nerja2012

You are exactly right . Protocols and pathways are very blunt instruments . They don’t allow for nuance or variation. It’s a one size fits all approach by necessity and if you feel you vary you have to fight your corner in whatever situation with your HCP. They are keen to stick to protocols because if they deviate and something goes wrong the patient can then turn on them and say” you are the expert you should have saved me from myself .” So they always document the discussion with copious notes . I had that with not taking ACs after my initial episode with an obvious cause, ( though cardiologist was ok with it ) and the “Why are you still on HRT ? “ Discussion . Naughty step for me !

Nerja2012 profile image
Nerja2012 in reply to Peony4575

I find the whole thing so confusing Peony. Especially as my Dad had a Warfarin related Death in his 60s .

Peony4575 profile image
Peony4575 in reply to Nerja2012

My Dad was a bit older but he had a bleeding tumour in his gut that bled so profusely because of his warfarin that although he didn’t die directly of the bleeding he had been so weakened by the bleeding he was too weak to survive surgery . I found him collapsed unable to lift his head because he was so anaemic ( I saw him daily and had taken him to the doctors several times because he was complaining of lightheaded ness and weakness and they had done an echo and various things but not checked his HB ). He hadn’t seen the bleeding because he had severe macular degeneration . He died in hospital two weeks later. Same practice told my mother her heart disease was stress and she died of a heart attack aged 56. I was a much younger and more trusting and naive person then, I don’t take anything doctors say at face value anymore . It is confusing and hard to know what to do for the best . I am where I am and if things change I will think again

Nerja2012 profile image
Nerja2012 in reply to Peony4575

Another point to add to the confusion Peony, my Mother Died aged 98. She also had AF and refused Anticoagulants but died of natural causes We are so alike with our stories and I'm so sorry about what happened to your parents. I guess im a lot older than you but both with the same backround. Its not an easy decision to take and I respect other peoples opinions and choices. As ive said before for me AF goes from A to Z in forms of frequency and severity. We are in the A's but if I moved up the alphabet I wouldnt hesitate. I know people will respond and say then why dont you take them now. Because thats my decision and also has to be respected, I value the advice on this forum as its been a great help since my diagnosis 5 years ago but at times I feel a bit of an alien because of my views.

Peony4575 profile image
Peony4575 in reply to Nerja2012

Well if you are an alien we are from the same planet . I found my Dads AF . He mentioned something to me and I just felt his pulse and he was in continuous slow AF. I think he had mentioned getting a bit puffed on his 5 mile walks . No idea how long he had had AF but no sign of a stroke and he was as fit as a flea . He might have been like your Mum. You are ten years older than me we are in the same ball park . Absolutely your/ my views should be respected as should everyone else’s. We don’t advise/push people to stop taking ACs and neither should the reverse happen . We are intelligent adults who have done our research and made our decisions on our particular circumstances . Nuff said ! X

Nerja2012 profile image
Nerja2012 in reply to Peony4575

Thanks for the responce Peony. I feel better now that someone understands.

Peony4575 profile image
Peony4575 in reply to Nerja2012

I do I do I do I do . Much nicer not being on ones own for both of us x

Ivan_the_Terrible profile image
Ivan_the_Terrible in reply to Nerja2012

thank God for people like you and Peony on this forum. My whole being rebels against the thought of taking ACs and I suspect it may do so for a very good reason and not just a romantic mysticism about 'being natural'.

Nerja2012 profile image
Nerja2012 in reply to Ivan_the_Terrible

You can join our group Ivan. Thats 3 of us now 😂

secondtry profile image
secondtry in reply to Nerja2012

I am another healthy alien, I am sure there are others!

Nerja2012 profile image
Nerja2012 in reply to secondtry

Thats 4 now 😂

Ivan_the_Terrible profile image
Ivan_the_Terrible in reply to Nerja2012

Is there anyway we could form a separate group. I can only reply to one member at a time, even if my reply might interest more than one member.

Nerja2012 profile image
Nerja2012 in reply to Ivan_the_Terrible

I'm not the one to ask Ivan as I dont have much knowledge about the group but I'm sure someone will reply to you. Its worth a try. Good luck.

Ivan_the_Terrible profile image
Ivan_the_Terrible in reply to Nerja2012

There used to be a Private Message facility but it's disappeared. I fear that trying to set up a small subgroup might be regarded as subversive.

Peony4575 profile image
Peony4575 in reply to Ivan_the_Terrible

I think it’s still there isn’t it ? You click on the person and message is an option

Peony4575 profile image
Peony4575 in reply to Ivan_the_Terrible

Technology isn’t my forte. Might there be some kind of way through a PM alert because you are very right . I would like to know what my fellow “aliens “are saying

Nerja2012 profile image
Nerja2012 in reply to Peony4575

Ivan will have to call the Group THE ALIENS 😂

Peony4575 profile image
Peony4575 in reply to Nerja2012

The aliens from Planet Mole ( going underground ). Mr Spock was an alien but he spoke a lot of sense and was mainly logical 😆 Live long and prosper ! X

Nerja2012 profile image
Nerja2012 in reply to Peony4575

I like that 😂

in reply to Nerja2012

Hello, there! I would like to join the group of aliens! Low weight, problems with AF for about 13 years, otherwise healthy, not on any medication, not on anticoagulants! Having views which are not always accepted by the forum members, lol!

Nerja2012 profile image
Nerja2012 in reply to

Your not on your own there Steel heart , The Aliens are coming 😂!!!!

saulger profile image
saulger in reply to Peony4575

...funny. Turning is easy, keeping it straight is the difficulty. Good health.

rosyG profile image
rosyG in reply to Nerja2012

It’s because the heart lining is not smooth like a young person so clots form (think how our skin is rougher now we’re older !! Blood isn’t pushed through firmly when the atria are fibrillating and gets stuck- often in the left atrial appendage. Clots often sit in the atria and get pushed out later into the circulation. Anticoagulants just delay clotting slightly so reduce the clot formation possibilities

Paulbounce profile image
Paulbounce

Far be it for me to disgree with Dr Sanjay Gupta. He know's much more than I. In fact his advice is second to none and I respect him fully - no doubt about that.

However afib (lone ot not) affects your chances of a stroke - certainly for afibbers in their mid 60's +.

A clot can form very quickly with afib - regardless of other factors.

That's my take.

Paul

BigArnie profile image
BigArnie in reply to Paulbounce

Thanks Paul. This is largely what is causing my confusion. It seems (?) that there may be no research directly linking Afib with strokes unless other comorbidities are present and yet it is also accepted (I think?) that Afib does result in a propensity towards blood clots...!

PlanetaryKim profile image
PlanetaryKim

Does anyone have the link the the particular video in which Sanjay Gupta says this? I would like to watch it. I really like him!

jeanjeannie50 profile image
jeanjeannie50 in reply to PlanetaryKim

I think this may be the video:

youtube.com/watch?v=LERfUhY...

PlanetaryKim profile image
PlanetaryKim in reply to jeanjeannie50

Thanks jeanjeannie! :)

Cumbremar5 profile image
Cumbremar5 in reply to jeanjeannie50

So helpful thank you so much for sharing this video

CDreamer profile image
CDreamer

Your title Does AF cause stroke or not? Invites a yes/no answer and it’s much more complex, as others have pointed out. It can’t be proved but there is a statistical link which signposts toward YES. What these studies have shown is that it’s estimated that 10-15% of all strokes are caused by AF but that the risk of stroke also increases with age and co-morbidities.

There are so many factors to consider that it would be almost impossible to eliminate all other factors other than ‘Lone’. AF in a large scale study.

I think the word ‘theorizing’ should be underlined and put in bold.

BobD profile image
BobDVolunteer in reply to CDreamer

CD I think what I have read also is that those strokes casued by AF acount for 80% of the least recoverable. The old 20/80 rule again.

BigArnie profile image
BigArnie in reply to CDreamer

Hi CD, it is of course complicated, although of course you don’t know that until you know that, if you see what I mean! Regarding “What these studies have shown is that it’s estimated that 10-15% of all strokes are caused by AF”, do you happen to have any references to relevant articles/studies please? Thanks.

BigArnie profile image
BigArnie

Hey John, I absolutely agree! On the other hand it also absolutely feels to me like an episode will lead to some kind of heart attack, which is apparently rather rare :-)

Without a documented 30 sec run of AF or flutter CHADS scores are not applicable. It’s not difficult to find a 10 year risk calculator of stroke without AF. Are you wondering about taking an a/c ?

opal11uk profile image
opal11uk

I have had A/F for over 20 years and it caused me to have a stroke, my cardio felt, when diagnosed, that I was too young to go on standard anticoags so she put me on 375 mg daily of Aspirin instead, after roughly a year I had the stroke and was hospitalised for 2 weeks, I then went on Warfarin and 3 years ago changed to Pradaxa. I agree with Finvola's overview.

Hambo444 profile image
Hambo444

The research I have seen is that there is about a 60 percent increase. This equates to 5 out of 1000 people within the general population compared to 8 out of 1000 people for those with AF (non-medicated)

Visitingcat profile image
Visitingcat

I think afib causes strokes because it gave me one. I think I could have had afib for around a year before going to the gp and being diagnosed but I put my symptoms of heart beating out out of my chest going upstairs and runs of fast beats down to being overweight and under a huge amount of stress at work.

Eventually went in with a “chest infection” as my chest ached and ached and I could barely finish speaking a sentence without running out of breath, I had never heard of afib, I was 57.

I was told I was at risk of stroke and watch out for symptoms, I waited 6 weeks to see a cardiologist and then 4 weeks to go on warfarin, week three of this I had a stroke.

I made a full recovery ( took a couple of days before I could speak properly which was very frightening ) they were surprised in hospital that I did so well.

After about twelve months the feeling of exhaustion finally seemed to go.

I wish I had been put on warfarin earlier and this might not have happened to me.

secondtry profile image
secondtry in reply to Visitingcat

You make a very good case for AF newbies not to waste time waiting and stump up for an initial private consultation (circa £200 + tests) as often advised here and I found it very worthwhile.

Visitingcat profile image
Visitingcat in reply to secondtry

Yes that’s true, it was a good few months before I found this forum, I found it when the cardiologist put me in for a cardioversion, I put a search in for “scared of cardioversion” and very luckily found Health Unlocked. I struggled with getting over a stroke in January and being in afib until cardioverted in June. This was 2013.

Until I found this forum I knew nothing, I had no idea that you could see consultants privately or any of the other knowledge that’s so available on here.

One of the scariest things about the stroke was that I had no idea what was happening to me. I did not know I was slurring my words, could not feel that my face had dropped, my husband saw it and phoned an ambulance, ten minutes later I would have been in bed. Dread to think what could have happened to me.

secondtry profile image
secondtry in reply to Visitingcat

Yes Health Unlocked is a great help. I have learned so much reducing anxiety and risks e.g. a very small lifestyle example last week somebody posted regarding strokes I think it was 'not doing shoulder stands anymore', some advice I have followed as at 67yo active and flattering myself as being fit I used to do!

Visitingcat profile image
Visitingcat in reply to secondtry

Wow, I would not be attempting head stands, defo not fit enough 😀When in afib just bending down to pick something up causes my head to swim and an awful pressure feeling.

I think it may have been Jeanjeanie said when getting out of bed always sit up slowly then sit for short while before standing up slowly, I always try to do this now, I think that was good advice.

lovetogarden profile image
lovetogarden in reply to Visitingcat

Visitingcat- what a terrifying experience you had with your stroke. So glad to hear you recovered so well after it.

Visitingcat profile image
Visitingcat in reply to lovetogarden

Thank you, even though it’s a good while ago I’ll catch myself thinking “l can get dressed myself, I can shower myself, I am so very, very grateful for the tv stroke ads, that my husband took notice and phoned straight away, that the hospital treatment worked for me ( it doesn’t for everyone unfortunately) Best wishes,

Vcat

lovetogarden profile image
lovetogarden in reply to Visitingcat

I can well imagine saying those things to yourself. And the gratitude that things worked out so well. ❤️ I had a TIA on Friday. And was grateful I knew the symptoms and realized what was happening. We got to the hospital quickly and I’m ok. And, like your husband, my husband now knows the symptoms and what to do. Crazy scary. Feeling very vulnerable at the moment. Good luck to us both!

Visitingcat profile image
Visitingcat in reply to lovetogarden

Oh I’m so sorry that has happened to you, I hope you can keep well in future and yes, good luck to us both 💐

Tomred profile image
Tomred in reply to secondtry

Hi second try how did you go about getting those tests do you see gp first and ask to be referred for private consultation and what tests do they do i have paf if not having episode at time of consultation do ýou think they can tell much if you know what I mean thanks

secondtry profile image
secondtry in reply to Tomred

It is a bit of a game. Suggest first you push GP to refer you to a NHS cardiologist. I was the same as you in that my GP initially thought she couldn't justify referring me as she didn't capture the PAF. Once you have a date (probably a long delay), I would contact the private cardiologist's (may be the same one) secretary and explain you wish to be seen more urgently and why. That way you are on both private and the NHS system as well and should be easier to get the expensive tests, if needed, done later with the NHS (assuming you don't have insurance), leaving you to pay privately for the consult and just an ECG plus maybe an echo cardiogram if required for the initial exam. Perseverance required and so unnecessary for a sick patient but that seems to be the way it is at present.

Tomred profile image
Tomred in reply to secondtry

Thank you second try i have been through gp and cardioverted after stress test had ecg ultrasound etc I thought maybe going private they may do some more maybe advanced tests?

secondtry profile image
secondtry in reply to Tomred

Nothing I can recall, 7 years ago now.

7164 profile image
7164 in reply to Tomred

TomredBob told me something important. He said most cardiologists are plumbers ( probably good plumbers) but we need electricians).see an EP !!

My local cardio just told me not to drink fizzy drinks !!!That was it!

Tomred profile image
Tomred in reply to 7164

EP told me not to drink coffee th at was it as far as nutritional advice and i know a few plumbers who are also sparks too

Visitingcat profile image
Visitingcat in reply to Tomred

When I had my first nhs consultation I had an echocardiogram there before I went in to see the cardiologist, I think if you had private consultation they arrange for it to be done on the nhs afterwards but not certain of this. I was stuck in afib all the time.

I have a kardia device and its great, I can always see what my heart’s doing if I feel anything untoward. Most times it’s normal so it’s reassuring. If you are not in afib all the time you can have proof of what’s happening and can show the doctor what your heart has been doing, mine keeps my history but you can screenshot. Sorry if I’m telling you stuff you already know : )

Tomred profile image
Tomred in reply to Visitingcat

👍👍👍

I have always understood there was notably a correlation between A Fib and stroke but a causal mechanism had been identified, namely pooling in left atrium causing a clot. I'll email Dr Gupta on this point, but any comments here are welcome.

Nerja2012 profile image
Nerja2012 in reply to Ivan_the_Terrible

If you get to speak to him Ivan. Please let us know what he says .

RaySyl profile image
RaySyl

Correlation? Causality? Who knows? If taking a coagulant lessens, to a greater or lesser extent, our chances of having a stroke then we would do well to keep taking the tabs! I was relieved beyond words when the Cardio who diagnosed my Afib put me on Warfarin. Whether or not Afib is in the genes, I dreaded ending up like may father, who had a massive stroke but lived for seven years in a pathetic state. If the Warfarin, and now the Apixaban, reduces the chance of that happening to me I will keep taking the pills!

Vrouse profile image
Vrouse

Unfortunately, I had a stroke caused by AF which I didn't know I had. I would have done anything to avoid it.

Kaz747 profile image
Kaz747

I don’t have any co-morbid conditions, although when my AF was bad my BP was erratic and my EP said any history of high blood pressure gives you a point (and I had high blood pressure in my pregnancies). I get a point for being female but there has been discussion about whether being female is really worth a point, and I’m in my 50s so below the 65yo age for anticoagulation recommendation.

That said, a few years ago, an ablation was abandoned when the TOE showed a blood clot in my left atrial appendage. I had been on anticoagulants up until two days before the procedure and the blood clot formed quickly. So had that clot traveled I could well have had a stroke. I will be on anticoagulation for life.

secondtry profile image
secondtry in reply to Kaz747

Hi Kaz, you raise a good point mentioned before here and that is if you start on ACs you should be on them long term as coming off them can actually raise the clot risk higher than before starting on them - I don't know the science but can see the logic. I am not on them but if I was and had to stop short term I would make sure I substituted other precautions as much as possible.

Kaz747 profile image
Kaz747 in reply to secondtry

My EP said the chance of forming a clot within such a short time was quite rare but hey, I do rare well 😀 and that’s why they always check before starting the procedure.

JJHRT profile image
JJHRT

Afib is a risk factor for strokes (just like high cholesterol is a risk factor for heart attacks)With afib there’s potential for clots to form in your atrial appendage which can then become dislodged and travel to your brain.

LaceyLady profile image
LaceyLady

I’m 63 and no anticoagulant, my score is low and Consultant said I’m at more risk if the anticoagulant than stroke, but says I’ll need it when I’m 65🤷🏼‍♀️

Why will I suddenly need it then? I’ve been given Apixaban and told it’s the ‘nicest one’ but I’ve seen reports of litigation.

wheezybronch profile image
wheezybronch

I have never heard of a chad score, I am on 40 mg Atorvastatin and a 75mg Aspirin everyday. I have had SVT's Atrial Flutter and Atrial Fibrillation. I have small vessel disease. I have had a successful ablation. I have experienced multiple Lacuna Infarcts, I believe AF contributed to the infarcts.

lovetogarden profile image
lovetogarden

Timely question. I just got home from a short hospital stay after a very short TIA late Friday night. I knew immediately what was happening to me and thank goodness it stopped very quickly. But we got to the hospital quickly, had lots of tests and still more to come. I have no stroke risk factors other than age and afib, so the docs were puzzled and perplexed about what to do with me, already on anticoagulants. Will be in touch with cardiologist tomorrow. Glad that it wasn’t “the big one” and happy to be home. Need to watch that Gupta video.

colin772 profile image
colin772

It's something I feel quite strongly about, I was diagnosed with an irregular heartbeat but wasn't put on anticoagulants. Around eight months later I had a TIA. It was very scary and then I was diagnosed as having AF after the TIA. I have now been on warfarin for many years without any problems. So yes, if you have the chance to be on anticoagulants, take it!

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