Dr Sanjay Gupta...AF and Strokes: Who... - Atrial Fibrillati...
Dr Sanjay Gupta...AF and Strokes: Who is the real daddy.
Thank you for sharing Steve. Cetainly food for thought. I'm half way through the video and will watch the rest a little later (business call's right now).
Ty Paul
Absolutely fascinating Steve and it answers the frequent question asked on the forum regarding 'is anticoagulation necessary if my AF is controlled'. Thank you for posting this - I feel I need to watch it again to take everything in. I suspect, too that we are looking at the start of a more targetted approach to AC in the future and hopefully saving more lives.
really interesting, in fact eye-opening. I found this the best video of his I have ever seen! Thanks for sharing.
kim
Excellent thinking, makes lots of sense. Thanks.
Many thanks for this . Dr Gupta thinks outside the box and allows his position to evolve unlike many others . I suspect the carpet bombing approach to prescribing ACs will continue for the foreseeable future. Does provide some targeted questions to ask if I have an echo .Really interesting !
Fascinating stuff Steve, thank you for sharing.
So sorry to hear the news of your loss Sanjay. Sending a big hug your way.
Jean
Really interesting, so fortunate to have this lovely man in our midst, thankyou Steve for posting.
sciencedirect.com/science/a...
Here’s an Australian paper from 12 months ago which talks about atrial myopathy. You can download the more readable pdf. I didn’t understand Dr Gupta’s hosepipe /balloon analogy. Raised LV pressure resulting in raised LA pressure, would suggest an incompetent valve.
Atrial myopathy has been an obvious though unsubstantiated risk factor for stroke for some time. Chads2Vasc scoring seems likely to remain a more affordable tool than serial MRI screening for atrial myopathy in determining the need for anticoagulants- though admittedly a much blunter one.
Fascinating and useful -thanks Steve. Ive been off blood thinners for a year now, due to them causing excessive bleeding. ....bit scary! I have a phone appointment with my electrophysiologist on Tuesday so this is very useful and timely information to discuss with him.
Fascinating. Thank you for sharing
Fascinating video from Sanjay Gupta. It seems to fit with my experience. I am now in permanent AF and last attempt at cardioversion was about three years. That was an internal cardioversion. At first it was successful and I felt great. Then three weeks later I was fibrillating again. To my surprise I still felt good and so after discussing it with the consultant I opted for no further treatment. Being almost asymptomatic allowed me to exercise more and coupled with a low carb diet I lost a lot of weight though never escaped the BMI category of being obese. It was a virtual circle. Felt better, more exercise, less over eating, felt even better. Thought I had cracked it. Then along came the covid lock down. Gyms closed and it became more difficult to exercise. Especially when we were deluged with rain. Put weight back on and started experiencing symptoms again. In Scotland we have to wait another week before the gyms re-open, but the prospect of the gym and the better weather has got me started on the exercise again. Small weight loss, about half a stone, but I have noticed symptoms are reducing and I'm hoping after a few weeks at the gym I will be back to where I was.
Good for you Nybroc.......wishing you well with the weight loss.
Thank you Steve for sharing this.I am a great fan of Dr Gupta’s videos.His logical and evidence based though is most helpful,and it make you rethink.His new Hypothesis is waiting to be evaluated more.What a brilliant mind,should be doing more medical research.
Very interesting. Thanks for sharing.
I found this paper about atrial myopathy , AF and strokes which gives a lot of detail.dx.doi.org/10.1016%2Fj.jacb...
I wonder, can one halt the process of atrial myopathy?
I was told my atria were slightly enlarged but can one prevent this worsening?
I was told my atria was slightly enlarged also and also wonder can this be reversed i think somewhere along the line of all my reading I did see that the atria can reduce in size with controlled meds for af i was told two years ago approx
Another interesting read and in conjunction with Dr Gupta’s video illuminating.
Maybe as is suggested cardiac ablation is the key ?
The article does suggest that successfully ablating the atria can reverse the process to some extent.
I tied to copy and paste the flow diagram showing this but failed.
Good question. I think we can do as much as we can using Lifestyle Changes which may actually mean less exercise for some, more for others so optimising the amount of exercise which will help. Doing anything which decreases stress - physical, emotional and psychological through stress management, nutrition and most important of all - making sure we get 7-8 hours of good quality sleep - which is how and where the body repairs itself.
Just watched this very interesting will go over it again soon to fully grasp details Dr Gupta is a godsend for info on heart issues
Dr. Sanjay Gupta is an absolute blessing to so many of us, can we please just appreciate him for a moment and send him positive energy for this tough time in his life.
Thanks Steve. Will listen to it again as if correct groundbreaking news which would seem to suggest the Framlingham study (I think it was called) with the conclusion AFibbers are x5 more likely to have a stroke was a misplaced conclusion from that data.
Fascinating. Could this mean those who only have certain comorbidities (no AF) would benefit from a reduced anti-coagulant as a prophylactic? Say, something as simple as low-dose aspirin?
Asprin is not an anticoagulant - it’s an anti platelet so no, baby asprin wouldn’t help and will increase bleed risk.
The argument for who and when anticoagulation be advised, if and when this hypothesis has been proved, is a much more nuanced argument.
Hypothosis need to be proved by evidence of cause/effect, not only through association.
I think it may lead to more nuanced prescribing for younger people who are otherwise well and fit when recently diagnosed, no hope for me then 😂
Very interesting! I have been ablated twice and don't live with any but a few errant beats now and then, so have cut my anticoagulant back to nighttime only (hate the bruising), but this new take on the cause of clot formation helps me see why it's still necessary to take my Eliquis as prescribed. My heart function tests don't show any problems, but at 74 and with erratic blood pressure, that's likely to be changing.
Exactly!
If my understanding is correct, far from less prescribing of A/Cs it could lead to more if and when myopathy is detected prior to development of AF.
This was fantastic. Thank you for sharing it. Off the back of watching that I also watched "two types of Afib" and that seemed to explain a whole lot of stuff I've never understood Viz why some people don't know they've got it while a 'young' 'fit' person like me is floored by it. Very goodThanks again
I think there is some truth in the idea that atrial myopathy can cause strokes. However I think it's only part of the answer. There is also a weak association between irregular rhythm and strokes in that successful ablations do reduce the risk of strokes a little. However, I think the real Daddy is inflammation, which can cause both AF and strokes. The mechanism appears to be inflammation of the interior of the heart surface. I think this was the cause of the TIA I had 12 years ago. I have subsequently worked to reduce inflammation, for instance by reducing the excessive exercise I was doing and ensuring I have no gum disease (also associated with AF and strokes).
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