|
|
Atrial fibrillation and Stroke Prevention |
Atrial Fibrillation is an irregular heart rhythm that arises from the top part of the heart.
Patients who have had a first episode of atrial fibrillation for more than 48 hours or recurrent episodes of atrial fibrillation should be considered for anticoagulation (thinning of the blood using a medication called Warfarin)
Warfarin reduces the risk of stoke in Atrial Fibrillation by about two thirds
Anticoagulation treatment is not risk free. There is a small but significant risk of major bleeding.
On warfarin 1.2% (12 people per 1000) will have a major bleed each year compared to 1% (10 people per 1000) in patients that take no treatment.
Regular INR tests are needed to monitor the bleeding risk. The recommended INR for patients with atrial fibrillation is 2-3 which means blood clots about 2-3 times more slowly.
Treating 1000 people with wafarin prevents about 30 strokes per year per year while causing about 2 major bleeds as complications.
Treating 1000 people with Aspirin prevents about 15 strokes per year.
Patients less than 60 years of age with no high blood pressure (hypertension) or known heart disease or any other risk for stroke probably do not need wafarin.
Those most at risk of stroke are over 60 years of age, with previous episodes of stoke, hypertension, diabetes or with heart disease.
If you feel your heart rhythm is different to normal you should talk to your doctor about arranging an ECG, which looks at the electrical activity of the heart. This test taken during a period of rhythm disturbance will allow atrial fibrillation to be excluded. If you experience shortness of breath or chest pain you should call for an ambulance and have the heart reviewed at Ballina Hospital immediately.
|
|
|
|
