“Atrial Fibrillation and Stroke Risk: Warning Signs and Prevention”

“Atrial Fibrillation and Stroke Risk: Warning Signs and Prevention”

2023-05-30 23:09:32

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Von: Andreas Beez

Warns of the consequences of cardiac arrhythmias, especially atrial fibrillation: the cardiologist Professor Alexander Leber from the Munich Isar Clinic. © Achim Frank Schmidt

Rapid, irregular pulse can be a warning sign of cardiac arrhythmia. “A stroke is imminent,” warns heart professor Alexander Leber.

Stroke nightmare: Every year around 270,000 people in Germany suffer from such a GAU in the brain. The consequences are often dramatic. They range from permanent disability to death. It is all the more important to know the risk factors and to realize alarm signals in good time. This includes an often rapid, irregular pulse. “Such symptoms can indicate cardiac arrhythmias. They are often the trigger for a stroke,” explains Professor Alexander Leber, Director of Cardiology at the Munich Isar Clinic.

Blood clots can travel from the heart to the brain and cause a stroke

“About every third stroke is triggered by cardiac arrhythmias,” says Leber. To be more precise, of atrial fibrillation, the most common cardiac arrhythmia. The insidious thing about it: “Atrial fibrillation itself is harmless. But this arrhythmia can set off a dangerous chain reaction. This can cause blood clots to form in the heart. These can then easily be washed into the brain with the blood flow and clog small veins there. As a result, brain cells die off within a short time,” explains Leber.

Cardiac arrhythmia: Blood-thinning medication is intended to protect against cerebral infarction

A brain as a graphic representation with cardiac arrhythmias
Cardiac arrhythmias can cause dangerous blood clots to form in the heart, which can travel to the brain and cause a stroke. © ALFRED PASIEKA/Science Photo Library

Most of the blood clots – known as thrombi in technical terms – form in the area of ​​the left atrium, the so-called atrial appendage. “Blood flow is reduced there during atrial fibrillation,” explains Leber. “For this reason, patients with an increased risk of stroke in atrial fibrillation are usually prescribed blood-thinning medication.” These include, for example, the classic drug Marcumar or modern successor drugs such as Xarelto, Pradaxa, Eliquis or Lixiana.

Cardiac professor Leber advises: regularly check your pulse yourself

When diagnosing atrial fibrillation, the doctor depends on the patient’s help. “In order to recognize atrial fibrillation in good time, you should feel and check your pulse regularly, for example on your wrist. If you often notice a kind of racing pulse, it is best to make an appointment with your family doctor or cardiologist and tell him about your experiences,” advises heart specialist Leber. In many cases, a normal ECG does not provide any more detailed information about atrial fibrillation because it is normal outside of these cardiac arrhythmias. That is why many doctors prescribe a long-term ECG if atrial fibrillation is suspected.

Normal heart rhythm is between 60 and 80 beats per minute

The normal heart rhythm is between 60 and 80 beats per minute. During physical or psychological stress, the pulse rate increases because more blood has to be pumped through the circulatory system. “Due to various influencing factors such as alcohol or coffee, even people without heart disease can experience occasional extra strokes. These are mostly harmless. Almost all of us have felt a heart palpitation at some point,” reports Leber. “However, if the heart’s conduction system is damaged, pathological arrhythmias can develop.”

Atrial fibrillation affects almost five percent of all people over the age of 64

In the case of atrial fibrillation, the atria are excited in a completely uncoordinated manner, and the blood flow in the atria is greatly reduced. “Almost five percent of all people over the age of 64 are affected by this disease,” says Leber. “Initially, this flickering only occurs for a few minutes or hours, we doctors speak of episodes. Later, this state can also be permanent. The typical symptom is an arrhythmic and usually rapid pulse, which is often perceived as palpitations or tachycardia.”

High blood pressure and diseases of the heart valves are often the triggers

According to heart specialist Leber, the most common causes of atrial fibrillation are high blood pressure and diseases of the heart valves, which over time lead to overstretching and enlargement of the atria. “In addition, an overactive thyroid gland or sleep apnea can trigger atrial fibrillation.” The risk increases with age.

Good chances of recovery with an intervention in the heart catheter laboratory

However, there are good chances of recovery. In addition to blood-thinning medication, so-called catheter ablation is also used. “During this procedure in the cardiac catheter laboratory, the conduction fibers in the atrium that cause the fibrillation are sclerosed with the help of high-frequency current or cold or laser balloons. Today, this form of therapy has a success rate of around 70 to 80 percent,” says Leber.

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