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Common Heartbeat Problem Increases Risk of Stroke

February 05, 2013

Learn more about Atrial Fibrillation at upcoming free health seminar

More than 2 million Americans have a type of irregular heart beat that increases their risk of having a stroke by five times. People who have this condition may experience serious symptoms, but some have no symptoms at all. The potentially elusive ailment, called atrial fibrillation or AFib, is described by the American Heart Association as the most common serious type of irregular heartbeat in people over 65.

"The odds of developing AFib increase with age," said Sanjay Bindra, M.D., a cardiac electrophysiologist specializing in the treatment of heart rhythms. Dr. Bindra is on the medical staff at Washington Hospital.

"AFib is also often associated with other health problems, such as high blood pressure or other heart and lung conditions," he added.

Atrial fibrillation-its symptoms and treatment options, as well as how it can lead to a stroke - will be the subject of a free Health & Wellness seminar, "Keeping Your Heart on the Right Beat," presented by Dr. Bindra on Tuesday, Feb. 19 from 1 to 2:30 p.m.

The event is open to the public and will be held in the Conrad E. Anderson, M.D. Auditorium in the Washington West Building next door to Washington Hospital at 2500 Mowry Ave. in Fremont. To reserve your spot, go online to www.whhs.com, click on Community Connection and select Community Seminars, Health Classes and Events, or call (800) 963-7070.

Fibrillation is a rapid, irregular, and unsynchronized contraction, in this case of the heart muscle. AFib occurs when the upper chambers of the heart, called the atria, beat erratically. This puts them out of sync with the heart's lower chambers, which are called the ventricles. People with AFib may have a racing, irregular heartbeat, fluttering in the chest or heart palpitations. They may feel weak, faint, dizzy or short of breath. Other symptoms include chest pain or sweating. Some people with AFib feel excessively fatigued when exercising, and some have no symptoms at all.

"Your doctor may have discovered you have AFib during a routine physical exam or testing for another condition," Dr. Bindra pointed out. "He or she can confirm the diagnosis by doing an electrocardiogram (EKG). Other tests will be used to look for the underlying cause and check for any complications."

There is a treatment option that offers relief to people suffering from frequent, annoying symptoms of Atrial Fibrillation. Called AF ablation, the procedure is performed by an electrophysiologist. Dr Bindra is a local expert on the treatment of this rhythm abnormality.

To perform AF ablation, the doctor inserts catheters into the heart through small tubes, and heat energy is applied to an area in the left upper chamber. The treatment prevents the heart from fibrillating. CT scans of the heart taken before the procedure and live X-ray and ultrasound images during the procedure help the physician navigate the catheters and treat the abnormal rhythm.

"AF ablation works by electrically isolating areas of the atrium, or upper chamber, that are important for the initiation or maintenance of atrial fibrillation," Dr. Bindra explained.

The decision to ablate atrial fibrillation must be a shared one between the patient and ablationist. Patients with unmanageable symptoms that impair their quality of life are good candidates for this procedure.

According to Dr. Bindra, the success of AF ablation depends on using it for the appropriate patient. Electrically isolating the pulmonary veins (the vessels that carry blood from the lungs to the heart) works to control AFib when those areas are driving and maintaining the disorder. He stated that this is most often the case with intermittent AFib, less often when the condition is persistent, and rare with long-standing AFib.

"After the ablation procedure it is important that the physician carefully follow the patient, who should continue on blood thinners," he recommended.

Dr. Bindra explained that one of the most important things to remember about AFib is that it puts you at nearly five times greater risk of having a stroke, even if you aren't experiencing symptoms. This is based on the way your heart pumps blood.
"When your heart beats irregularly, it doesn't pump blood as it should and this can cause blood to pool in the upper chambers of the heart," Dr. Bindra stated. "This pooling can cause a blood clot to form in your heart, and the clot can break away and travel directly to your brain, where it can block an artery and cause a stroke."

At the seminar, Dr. Bindra will talk about new drugs that are now available to help reduce an AFib patient's risk of stroke. He'll also discuss treatment options that can give relief from the annoying symptoms experienced by some people.
"You can work with your doctor to develop a plan that will help reduce your risk of stroke," he reported. "Taking medicine for this purpose is a key part of treatment for many people with AFib."

For a long time, the drug warfarin has been taken orally by AFib patients as an effective blood thinner. However, it requires frequent blood monitoring, individualized dosage, and restrictions in what patients can eat.

"Now, for patients with AFib not caused by heart valve disease, there are new blood thinners that are just as effective, if not better, and just as safe, if not safer," said Dr. Bindra. "These medicines can reduce stroke risk in patients, who should continue to be closely monitored for bleeding problems."

Studied in tens of thousands of cases, these medications are more convenient for patients. They have a fixed dose that can be adjusted to the patient's kidney function based on the results of a simple blood test.

Learn more

For more information about atrial fibrillation (AFib), visit the Web site of the American Heart Association at www.heart.org. For more information about Washington Hospital, visit www.whhs.com.

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