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Atrial Fibrillation Gone? You’re Still at Risk for Stroke

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Your doctor has given you good news. Your atrial fibrillation (AFib)—an irregular heartbeat that greatly increases stroke risk—has gone away. Your heart rhythm has returned to normal.

But you’re not out of the woods, according to new research. You’re still at increased risk for stroke—and you might need a drug to counter that risk. In a study in The BMJ, researchers examined the records of about 50,000 patients in the UK, 11,000 of whom had a history of AFib but whose physicians had determined it was resolved. Some had undergone treatment to eliminate AFib, while others had experienced a spontaneous return to normal heart rhythms.

Key finding: These patients were not only still at higher risk for stroke than people who had never had AFib, their risk was similar to that of people with ongoing AFib.

How could that be? For one thing, AFib can come and go. The heart may resume its normal rhythm for a time, prompting some to consider the condition “resolved,” even “cured.” Plus, treatment effects can diminish over time. Example: One out of four patients treated successfully with catheter ablation, which uses radiofrequency waves, has his/her AFib return within a year.

Finally, while some patients with AFib have symptoms (heart palpitations, extreme fatigue, lightheadedness, confusion, shortness of breath), others have none. So the first “symptom” that their AFib has returned may unfortunately be a stroke.

Most patients whose AFib has been resolved spontaneously or through treatment, study authors concluded, should not stop taking stroke-preventing ­anti­-coagulant medication such as warfarin (Coumadin) or rivaroxaban (Xarelto). Even if you’ve been successfully treated for AFib, talk to your doctor about these medications.­

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Source: Tom Marshall, PhD, professor of public health and primary care in the College of Medical and Dental Sciences at University of Birmingham, UK. Date: October 1, 2018 Publication: Bottom Line Personal
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