Can very short episodes of AF lead to a stroke?

[John3333333]

I experience short bursts of AF. The episodes don't last for more than 5 seconds, and occur about 3 times a week. Information about whether or not these short episodes are considered a stroke risk is limited. Does anyone on this forum have any information, advice or opinion on this matter? Thanks.

[CDreamer]

There are no certainties with AF nor with life so it’s impossible to say. I don’t know of any studies but I would highlight the risk algorithm that most people use to assess risk which is CHADSVASC score which should also be balanced with HASBLED scorel

chadsvasc.org

I do seem to recall someone recently posting a link about new study around stroke risk and ectopics so if they see this post, maybe they will chip in?

If you score less 2 then anticoagulants may not be recommended but 1 and more you should have a conversation with your doctors to discuss but know that opinion, including expert medical opinion, varies and there are no hard, fast rules.

It is not the length of time in AF which is the most significant factor but the company AF keeps ie: Hypertension, weight, fitness, heart structure and other co-morbidities such as diabetes you need to be more concerned about.

[Jafib53]

Sorry, I can't answer your question but can I ask how you know you are having these episodes and can you tell it is AF and not say, a short bout of tachycardia? I sometimes wonder if I maybe have similarly short bouts but not sure how I would know.

[secondtry]

From what I have read and learned from my cardiologist, would say highly unlikely unless you have other health complications and don't combine good exercise in your daily routine.

I would however make it a priority to talk to your cardiologist (private appointment?) to discuss it and and how to stop it. It may be a batch of lifestyle changes including taking supplements would help without medication.

[Ennasti]

My EP put me on apixiban and my AF episodes are similar to yours. He obviously believes there is a risk for me. I’m female and 57, and I’m medicated for blood pressure.

[JOY2THEWORLD49]

Hi

It only needs the blood stream sluggish and not getting around your body regularly could cause a clot which could get stuck in any artery to the brain or in the brain.

On no meds except B12 for deficiency, I had a stroke at 2am and I suddenly awoke at 2am. My H/R then is 47bpm average on all 3 x 24 hr monitor.

I had a sore head!

I trotted to toilet, and went back to bed without looking in the mirror.

I awoke again at 5.30am. Looked in mirror. Couldn't drink, eat and right hand with dropsy. I couldn't tell the 111 where I was. So I grabbed the homephone that did get my location correct.

Off to hospital I went. On the 4th day when a carotid scan was done and the lass exclaimed that I had a shadow on my thyroid. A biopsy showed Papillary Cancer. 4 mths later removed with 12 right lymphs. 2 affected. I was lucky.

So there is a risk. I take PRADAXA 110mg x twice daily.

cheri JOY. 74. (NZ)

[Confused01 in reply to JOY2THEWORLD49]

Hi,Read your reply with interest as correlates with heart and thyroid. Sorry to hear of your diagnosis...Thank goodness it was picked up on.

What scan did they do that showed both caratoud and Thyroid?

I'm diagnosed with Bradycardia but recently also thyroid gland vascular abnormalities. Thyroid bloods normal.

I have read that thyroid issues can cause heart beat irregularities.

Appreciate any info as I'm getting nowhere with nhs tbh.

Thanks

[JOY2THEWORLD49 in reply to Confused01]

Hi

It was called a Carotids Arteries Scan or Ultra Sound. There are two carotids.

I heard the lass say "I do two for the price of one". "Oops you have a shadow on your thyroid". "I had better get the boss in to look."

Then the weekend after I was transferred to a local hospital a doctor rung to ask if I ould give permission for a biopsy. "Yes" I said.

Biospied and diagnosis A carcinoma in my right lobe 1.9mm. Another surgeon picked up a tiny carcinoma in left lobe. He removed 12 lymns as well. 2 affected with papillary cancer. cheri JOY

[Thomas45]

Reading your previous posts, you've previously had a racing heart and an ablation. So your question needs to take into account your history, not just isolated five second episodes.I cannot advise but in your situation I would be happier if I was taking an anticoagulant.

[custard1]

I would think very little chance of a clot forming based on my understanding on this. I must say I have no medical background, but I've never been put on anticoagulants when in af, due to my chadvac score, but a few seconds seems very unlikely to me to form a clotI did see this on a medical site

The traditional concept proposes that atrial thrombus forms only after > 2 days of AF and embolizes by being dislodged from increases in shear forces. This widely accepted concept further holds that newly formed atrial thrombus, in the setting of AF, organizes over a span of 14 days.

[ozziebob in reply to custard1]

I am genuinely and personally interested in the development of atrial thrombi, so would appreciate any research links you can provide for your statements about >2 days and 14 days in your final paragraph. Thanks. Bob.

[custard1 in reply to ozziebob]

Hello Bob I'll try and find it again, I'm working currently so may be a while

[Auriculaire in reply to custard1]

I have never had an afib episode that lasted more than14 hrs and on average they last 8-12 hours. Nevertheless I had a TIA six months after the previous afib episode. I suppose it might have had nothing to do with having PAF but I certainly would not be inclined to believe in this traditional concept.

[Confused01 in reply to Auriculaire]

Hi,Can I ask if your again episode left you virtually unable to use limbs, profuse sweating and very white? Sudden? Then subsides slowly over 8-24 hours ish? Obviously I am trying to compare wuth my episodes. 🤨

[Auriculaire in reply to Confused01]

No it was extremely subtle. I was gardening and when I got up I felt a slight weakness in my right leg. It did not last. But I felt "odd". I could talk but it was like there was a disconnect between my brain and my tongue. That passed very quickly too. But it was the next day when I tried to write the shopping list - my writing was just squiggles. I went to the doc who sent me for a brain scan. Nothing showed but he was convinced it was a TIA.

[Tellingfibs]

I also have very short bursts of Afib, but both my GP AND my cardiologist told me that the clot that can form and cause a stroke might only need one very small run of Afib to develop.

Annie.

[mjames1]

Some experts would say any duration of afib increases stroke risk. Others say hours or days. But I think the overriding issue in your case is that you previously stated your CHADSVASC score is Zero. I don't think I have your occasional sub clinical 5 second afib episodes anymore, but I'd think I'd trade them for a CHADS of 0 So personally, would not lose any sleep over this, unless your doctor has a different take.

Jim

[JaneFinn]

I’m really intrigued by your question, and everyone’s replies, as my EP has always said that any arrhythmia of a few seconds duration doesn’t really ‘count’ - in fact in most cases he’d say there’s no need to identify it as a particular kind of arrhythmia unless it’s longer. I may be remembering wrongly but that was my understanding. I have a whole load of short bursts (5-15 seconds) of various kinds of arrhythmia. So I listen to your replies with interest!

[estesbubba]

There was a recent study that showed that an AFib burden of 11.4% or more is where the stroke risk greatly increased and there was no association with the length of the events.

afburden.com

[mjames1]

medscape.com/viewarticle/99...

[John3333333 in reply to mjames1]

Very interesting read. I'll keep a look out for the ARTESiA trial results too.

[mjames1 in reply to John3333333]

Also follow the React-AF trial in the US on pip thinners.

clinicaltrials.gov/study/NC...

Jim

[Silky57 in reply to mjames1]

Thank you so much for posting this. Very interesting to see emerging scientific evidence of what seems instinctively likely.

[baba]

“The episodes don't last for more than 5 seconds, and occur about 3 times a week.”

Are you aware of those episodes or how you are measuring them?