Today we are celebrating a huge miles... - Atrial Fibrillati...

Atrial Fibrillation Support

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Today we are celebrating a huge milestone, as the NHS marks 75 years of service šŸŽ‰

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Atrial Fibrillation (AF) is a leading cause of stroke. AF-related strokes are more disabling and often fatal, more than any other type of stroke. Together with the NHS we can detect AF, protect against AF-related strokes and correct irregular heart rhythms. Thank you NHS for your hard work and dedication to those living with AF.

Happy birthday NHS šŸ’™

Find out how you can support the NHS here: england.nhs.uk/nhsbirthday/...

#NHS75 #NHSBirthday #HappyBirthdayNHS

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Threecats profile image
Threecats

Hi Tracy

Whilst I totally agree with your sentiment regarding the NHS I feel I must query your opening statement that: ā€œ AF is a leading cause of strokeā€. Could you advise what data this statement is based on, please? I had previously thought that high blood pressure was the leading cause of stroke.

My understanding is that the chance of me having a stroke as an AF sufferer is increased if I have any of the risk factors as outlined in the CHA2DS2-VASc risk calculator, rather than having AF alone . I further understand that the risk of me having a stroke is between 1 -20% depending on the number of risk factors I may have but it would seem, if your statement is correct, I have got that wrong.

I am not, for a minute, disputing the increased stroke risk that AF brings with it, nor the fact that a stroke caused by AF is often more devastating than strokes from other causes. However, I am concerned that those of us of a younger age with AF alone and no other risk factors and therefore deemed not to require anticoagulation at this stage may be alarmed by your rather sweeping statement.

I look forward to hearing from you,

Best regards, TC

mjames1 profile image
mjames1 in reply to Threecats

Tracy said, afib "is a leading cause of stroke" which is correct. But high blood pressure is THE leading cause of stroke, so you are correct :)

If you have afib, your stroke risk may or may not be increased over the rest of the population, depending on both the ever evolving CHA2DS2-VASc and other factors not yet in the CHADS calculation, such as frequency of episodes, fitness level and how well you might have controlled risk factors such as blood sugar and the big one again, blood pressure.

nhlbi.nih.gov/health/stroke...

Jim

Threecats profile image
Threecats in reply to mjames1

Hi Jim

Thanks for the link which is interesting to see. However, I note that AF is lumped in with cardiovascular disease, rather than being classed as a major cause of stroke in its own right, so I would beg to differ with you on your assertion that AF alone is a leading cause of stroke, sorryšŸ˜Š

As you say in your second para, stroke risk ā€œmay or may not be increasedā€¦..ā€ etc. Thatā€™s my point really, I would suggest it isnā€™t as black and white as Tracyā€™s statement would appear to imply.

TC

mjames1 profile image
mjames1 in reply to Threecats

This (see below) suggests afib causes 1 in 7 strokes. To me that IS a leading cause of stroke :) But as mentioned, not THE leading cause. But I think more pertinent to you (or all of us) is what is OUR individual risk of stroke. And that can be computed using the current CHADS score, as well as some of the other things mentioned previously.

webmd.com/heart-disease/atr...

Jim

Threecats profile image
Threecats in reply to mjames1

I agree Jim , if the 1 in 7 figure is correct and is read as meaning AF by itself being the sole cause but is that what itā€™s saying? Without any references to back up the claim itā€™s impossible to say and, given that the article then goes on to discuss the various risk factors that increase the likelihood of a stroke, I would suggest the figure isnā€™t referring to AF only. I appreciate WebMD is for general public consumption but I still think more detail needs to be given if such figures are being ā€˜ put out thereā€™. Iā€™m sure you recall the lively debate that followed a now sadly ex-member querying the oft quoted 5 times the risk figure, so Iā€™ll not go down that rabbit hole again! I think weā€™ll just have to agree to disagree on this onešŸ˜Š

You are quite right, though, our individual risk calculation is more pertinent. My concern ,and why I raised the query in the first place, is that newly diagnosed folk who may be perusing the forum for advice may not be aware of the nuances of stroke risk calculation and for them such a broad statement could well be very concerning.

Popepaul profile image
Popepaul in reply to Threecats

There is a video by the York Cardiologist in which he endorses your view. I watched it awhile ago. I think he says that he is not convinced that Afib causes stroke. He explains why and he goes on to refer to an amalgam of causative factors.Your 2 responses make some good points and are well written.

Regards

Threecats profile image
Threecats in reply to Popepaul

Thank you Popepaul. Yes, I have also seen Dr Guptaā€™s video on the subject and found it very interesting.

All the best TC

kocoach profile image
kocoach in reply to Threecats

I was made to understand when you are in afib your atria and ventricles are not in sync and the ventricles don't push the blood out that you need fast enough thereby causing blood to pool which thereby causes blood clots, hence is why so many Drs. put us on anticoagulants to prevent clots and stroke. If I am wrong please forgive me but this is my understanding why afib can cause a stroke. Have a Blessed Day. PS I've had afib for 32 years now.

Threecats profile image
Threecats in reply to kocoach

Hi kocoach

Indeed so, the atria and ventricles are out of sync in AF and the ā€œquivering ā€œ or fibrillating of the atria can give rise to the formation of clots as the blood isnā€™t flowing smoothly through the heartā€™s chambers. My argument wasnā€™t that AF is a source of strokes, as I agree that stroke risk is increased with AF, in particular when other comorbidities are present - high blood pressure, diabetes etc. Rather, my problem is with Tracyā€™s first statement - that AF is a leading cause of stroke. I have not come across anything in my researches on the subject that supports the statement that AF, by itself, is a leading cause of stroke, so I would be interested to know what data is supporting Tracyā€™s statement.

Best regards TC

Rosie1066 profile image
Rosie1066

A Big ā€˜THANK YOUā€™ to the NHS. I am eternally grateful.

Back in June this year I was admitted through A&E to hospital with AF and dizziness. Much to my amazement, two weeks later I was discharged having been fitted with an express Pacemaker! Fantastic service when you actually need it and something I certainly wasnā€™t expecting.

baba profile image
baba

Without the NHS I wouldn't still be alive

john-boy-92 profile image
john-boy-92 in reply to baba

Me too. The NHS team wanted to ring my wife at 1:15 am, but I said no. The follow up a few weeks later with a hospital doctor started with; "you nearly died". The positive outcome was the case consultants writing a paper (Royal College of Physicians, Edinburgh - Case of the Quarter) that identified dronedarone and amiodarone as the cause of my pulmonary toxicity (aka cryptogenic organing pnuemonia). Hopefully, other people with AF won't be prescribed those drugs, and if they are, there is wider knowledge of pulmonary toxicity indicators, so people won't be wrongly diagnosed as having community aquired pnuemonia and, incorrectly treated so they become hypoxic with risk of dying or disability.

LaceyLady profile image
LaceyLady in reply to john-boy-92

oh joy not! My Consultant HAS put me on Dronedarone! So now Iā€™m worried. I have Haemochromatosis which is an iron overload problem which is a liver issue. I know that Iā€™m supposed to have liver checks and very 2 months but thatā€™s not taking into account the Haemochromatosis šŸ˜³

CDreamer profile image
CDreamer

Let us all hope that it is alive and kicking at 100.

Over the past 9 months, the NHS has excelled itself for my wife but we know that itā€™s not been the same for everyoneā€¦ā€¦ā€¦.

Singwell profile image
Singwell

I'm so grateful to have had two ablations within 2 years - one of them when the pandemic was still pretty bad - at an excellent hospital without having to pay! That's what the NHS means. Our hospital medics were heroic during COVID. Like CDreamer I just hope our health service remains and grows.

john-boy-92 profile image
john-boy-92

Hi Tracy. The problem is that there isn't a national policy on screening for AF. My local primary care network (PCN) won't even check for arrythmia because of that: I suggested informally using a finger oximeter with a waveform display during a face-to face for anything. I'm told by the PCN (and an email chat with Trudie Lobban) that the NHS are waiting for the results of the Cambridge University SAFER study into AF. Whilst that study will produce an interim report, the full report will not be available for five years! Further, the lived-experience participants in the study are 70 + years old. I have raised this with a local cardiologist to discuss with the Integrated Care Board and Stroke Board. In Bristol, Hyper-Acute and Sub-Acute Units opened this May, but we have to reduce the number of stroke admissions. Screening for undiagnosed atrial fibrillation could be part of that.

Deejay62 profile image
Deejay62

Congratulations to all who work in the NHS. I hope by some miracle it continues to see 100 years.

mountainwalk profile image
mountainwalk

The NHS has some od the worse outcomes of the western world. It should have been scrapped and replaced years ago. I had my first AF episode 6 months ago and still haven't seen a cardiologist since I left hospital. Many people are dying everyday because of their incompetence. I am not talking about medical staff just the enormous beaurocratic organisation.

LaceyLady profile image
LaceyLady in reply to mountainwalk

My autistic mentally challenged brother died in Milton Keynes hospital last July, asphyxiation, had restricted airway not noted , given increase of a medication that causes drowsiness and then a tuna sandwich which caused the asphyxiation

Finvola profile image
Finvola

The NHS saved my husband's life a couple of weeks into lockdown - he received exemplary care which has continued for the last 3 years. I wish all parts of the country were as well served . . . . .

LaceyLady profile image
LaceyLady

The wonderful NHS is only as good as the area youā€™re in and the hospital you are assigned to.

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