The Importance of Anticoagulants and Stroke Prevention in AFib Patients

Dr. Frank Halperin, MD, FRCPC, Cardiologist, discusses the importance of taking anticoagulants for stroke prevention in patients with Atrial Fibrillation.

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Dr. Frank Halperin, MD, FRCPC, Cardiologist, discusses the importance of taking anticoagulants for stroke prevention in patients with Atrial Fibrillation.
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Featuring Dr. Frank Halperin, MD, FRCPC, Cardiologist

Duration: 4 minutes, 19 seconds

Atrial fibrillation is one of the most common arrhythmias heart rhythm disorders that we see. In fact, everyone has a one in four chance of developing atrial fibrillation in our lifetime. Why is that important? Well, if you develop atrial fibrillation it increases your chance of a devastating condition called stroke. And in fact, it increases that likelihood by five times.

What is a stroke? A stroke is when a part of the brain dies because of lack of oxygen. And that occurs in atrial fibrillation because the part of the heart that fibrillates, or vibrates, the atrium, can have blood pool within it.

When that happens, the blood will clot, and that clot can then break off and move, and if that should travel up to the brain, that part of the brain won’t receive the oxygen that it needs, and the patient will suffer a stroke.

Since the atrium is a very large chamber, the clots can be quite large, and the strokes can be very large as a result of that, and they can be quite devastating, resulting in significant problems for that patient, and even result in death.

So given this, atrial fibrillation is a very important condition to know about, and is a very important condition for your doctor to be aware of, so that you and your doctor can work together to keep your stroke risk as low as possible, and to prevent you from having a stroke in the future.

If you’re diagnosed with atrial fibrillation, your doctor will try to assess what your risk of having a stroke is. It doesn’t matter whether you have atrial fibrillation intermittently or continuously, you’re symptomatic or not, you still have a risk of stroke, and as I indicated before, that risk is about five times your baseline risk.

Your doctor will look at other factors that you have, such as your age, presence of other health conditions, and from that define what your risk per year of having a stroke is. If that risk is high enough, it may warrant treatments such as anticoagulants or blood thinners to reduce the likelihood of blood clotting within your atrium and as a result reduce your risk of having a stroke in the future.

For patients with atrial fibrillation, we want to reduce stroke, we tend to use a group of medications known as oral anticoagulants. Our standard medication is Warfarin, which has been around for 60 years. We know this medication well, it is effective, but unfortunately it interacts with medications and foods, and as a result you need to have blood tests done regularly to make sure the medication is at the proper effect.

We are lucky now that we have four new medications that are much more predictable, and all you have to do is take the dose regularly, and if you do that, the medications will thin your blood to the proper level.

This is obviously an advantage over the older agent and is one of the reasons we tend to use these medications preferentially. As well, these medications are at least as effective as Warfarin in preventing stroke, and they also have the benefit of having less bleeding side effects, particularly the most serious or life threatening type bleeding, we see this certainly less with the newer agents as compared to Warfarin.

Oral anticoagulants are very effective medications to prevent stroke. For them to work, however, it’s important that you take your medications as prescribed on a regular basis. With this we’ll have the lowest chance of having a stroke and as well, the least chance of having any complications or bleeding issues.

If you have atrial fibrillation, to reduce your chance of stroke, oral anticoagulants play a major role, but there are other things that you can do to help yourself. These are things such as eat a healthy diet, exercise on a regular basis, keep your weight at close to ideal values, don’t smoke, don’t drink to excess, look after yourself, take your medications on a regular basis as they’re prescribed, and keep in close contact with your nurse practitioner, your family physician and your cardiologist.

These things together will help reduce your chance of having a stroke and make you have the best chance of things going well for you in the future. If you have any further questions about atrial fibrillation and in particular stroke prevention, I strongly encourage you to discuss this further with your family doctor or your cardiologist. They’ll be able to provide more information about your particular condition.

Presenter: Dr. Frank Halperin, Cardiologist, Kelowna, BC

Local Practitioners: Cardiologist

This content is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding a medical condition.

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