Understanding atrial fibrillation and stroke risk

Atrial fibrillation (AFib) is a common heart condition. In fact, it affects up to 2.3 million adults in the United States. What you may not know is that AFib significantly increases your risk of stroke. Here’s what you need to know about the connection between AFib and stroke.

The link between AFib and stroke

Strokes occur in one of two ways: a disruption in blood flow to the brain (ischemic stroke) or bleeding in the brain (hemorrhagic stroke). A stroke is essentially a brain attack. “Atrial fibrillation is not the only cause of a stroke, but it is a major one—up to 25% of all strokes occur because of AFib,” explains Gan Dunnington, MD, cardiothoracic surgeon with Adventist Health St. Helena. And people with AFib are more likely to suffer higher severity strokes, meaning the stroke is more likely to cause permanent damage or disability.

In your heart, you have a small pouch called the left atrial appendage. “We call the left atrial appendage the ‘stroke center of the heart,’” Dr. Dunnington says. “When you have atrial fibrillation, your upper heart chambers aren’t really beating as they should, so blood sits still. The result is that blood clots can easily form in that left atrial appendage.” When these clots form, they can move from the heart to the brain, leading to a stroke.

Lowering your stroke risks

The good news is that receiving treatment for AFib can also lower your stroke risk. “Reducing stroke risk is a significant portion of AFib treatment,” explains Dr. Dunnington. “Although untreated AFib can lead to problems like heart weakening and full-on congestive heart failure, lowering stroke risk is one of the biggest factors for why people need AFib treatment.”

The first line of treatment for atrial fibrillation typically includes blood-thinning medications. While blood thinners don’t correct AFib, they can decrease your stroke risk by up to 60%.

“Medication is very effective,” Dr. Dunnington says. “But there are some patients who want other options.” Some people aren’t comfortable with the bleeding risks associated with blood thinners, including people who enjoy higher-risk activities like skiing or hiking. For some people, prescriptions feel out of reach cost-wise, while others simply don’t want to be on a daily medication for the rest of their lives. Thankfully, there are other treatments that many people with AFib can benefit from.

Treatment beyond medication

At the Adventist Heart & Vascular Institute, the team offers a range of atrial fibrillation treatment, including:

• Cardioversion. This treatment involves shocking the heart back into normal rhythm to treat AFib. Cardioversion is often effective short-term, but the results are usually not permanent.
• Catheter ablation. With this technique, your doctor goes through a vein in the groin to get a catheter (long, hollow tube) to the heart. Then, they aim to ablate (destroy) the specific cells that cause AFib. This technique has similar effectiveness as medications.
• Hybrid maze surgery. This operation combines techniques from catheter ablation with surgery. It is only available at a handful of medical centers in the United States, including the Adventist Heart & Vascular Institute. To reduce stroke risk, surgeons place a titanium clip on the left atrial appendage. Even if a patient has recurrent AFib, this procedure significantly decreases stroke risk.
• WATCHMAN procedure. This surgery specifically lowers stroke risk by placing a small implant to permanently close the left atrial appendage. For patients who can’t take blood thinners or have a history of bleeding problems, the WATCHMAN procedure can be a good alternative to medication.

“Our specialists have a broad experience in treating AFib from all different angles,” Dr. Dunnington shares. “It’s important for patients to talk to experts who understand all the treatment options.”

How do I know what treatment is right for me?

It’s important to know what options are available in your area and are appropriate for your specific needs. If you want to know more about treatment options beyond medication, speak with your healthcare provider. “Many people who end up in my office tell me they didn’t even know there was another option,” Dr. Dunnington says. “These treatments can significantly improve a person’s quality of life.”

To get treatment for AFib or another heart condition, find an Adventist Health provider today.