Could screening for atrial fibrillation result in fewer strokes?

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According to strokecenter.com, nearly 795,000 strokes occur in the U.S. every year, and they kill more than 140,000 people.

But a new study suggests that you might be able to reduce risk earlier if you find one of its causes first.

One of the leading causes of a stroke is irregular heartbeat, or atrial fibrillation, which up to 6.1 million people live with in the U.S.

"Some studies have suggested that the lifetime risk of having at least one episode of atrial fibrillation is one in four," said Dr. David DeLurgio, a professor of medicine at Emory University.

Every 40 seconds, someone has a stroke. But knowing someone has atrial fibrillation early might pose an advantage.

"Is this patient at risk of a stroke? If so, we'll typically treat that patient with a blood thinner," DeLurgio said.

Blood thinners reduce the risk of stroke from 4% to 1%, and the risk of death decreases from 7% to 4%. So, why not screen for the heart condition?

A group of experts recently debated the topic and concluded that while this could maximize treatment, the risk would be misdiagnosing a patient, causing someone to bleed or have unnecessary discomfort.

If you want to start checking your heartbeat yourself, you can download the FibriCheck app on your smartphone, which uses your camera to detect irregular heartbeats.

If you have an Apple Watch, download the KardiaMobile app and get a KardiaBand, which is a Food and Drug Administration-approved device that senses your heartbeat.

CardiacSense is another app that will send your electrocardiogram to your doctor when it is irregular. This app is still waiting to be approved by the FDA.

One possible solution is the reading of an ECG, which records the electrical activity of the heart by a clinician. But a study in South Korea showed that 10% of ECGs were overread, causing patients to be overtreated and have anxiety attacks from their misdiagnoses.

SCREEN FOR AFIB, FEWER STROKES?
REPORT #2654

BACKGROUND: Atrial fibrillation, or AFib, is the most common type of heart arrhythmia. An arrhythmia is when the heart beats too slowly, too fast, or in an irregular way. When a person has AFib, the normal beating in the upper chambers of the heart (the two atria) is irregular, and blood doesn't flow as well as it should from the atria to the lower chambers of the heart (the two ventricles). AFib may occur in brief episodes, or it may be a permanent condition. An estimated 2.7–6.1 million people in the United States have AFib. With the aging of the U.S. population, this number is expected to increase. Approximately 2% of people younger than age 65 have AFib, while about 9% of people aged 65 years or older have it. African Americans are less likely than those of European descent to have AFib. Because AFib cases increase with age and women generally live longer than men, more women than men experience AFib. (Source: https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_atrial_fibrillation.htm)

RISKS AND TREATMENT: The risk for AFib increases with age. High blood pressure, which also increases in risk with advancing age, accounts for 14% to 22% of AFib cases. Some other risk factors for AFib include obesity, diabetes, heart failure, hyperthyroidism, chronic kidney disease, heavy alcohol use, and enlargement of the chambers on the left side of the heart. AFib increases a person's risk for stroke by four to five times. Strokes caused by complications from AFib tend to be more severe than strokes with other underlying causes. AFib causes 15%–20% of ischemic strokes, which occur when blood flow to the brain is blocked by a clot or by fatty deposits called plaque in the blood vessel lining. Some treatments for AFib can include medications to control the heart's rhythm and rate, blood-thinning medication to prevent blood clots from forming and reduce stroke risk, surgery, and medication and healthy lifestyle changes to manage AFib risk factors. (Source: https://www.cdc.gov/dhdsp/data_statistics/fact_sheets/fs_atrial_fibrillation.htm)

BREAKTHROUGH AFIB CARE: Sanjiv Narayan, MD, PhD, is a Stanford doctor with a very particular
specialty: cardiac electrophysiology. Narayan, who now directs Stanford's atrial fibrillation program and its electrophysiology research, had long been interested in detecting the points of electrical chaos in the heart that cause AFib. As a board-certified doctor who also has advanced degrees in neuroscience and software engineering, Narayan's two decades of research and development produced an important new tool: FIRMassisted ablation. FIRM — focal impulse and rotor modulation — is a combination of optical mapping, based on computational analysis, which pinpoints the exact electrical sources of the fibrillation within the heart's tissues. Those sources, called rotors because of their circular shape, can then be destroyed with heat in a catheter-based procedure. The rotors had long been suspected, but never before mapped as distinctly as Narayan's new patented technology was able to do. With that improved precision, most patients treated with FIRM-assisted ablation need only one procedure to end their AFib. (Source: http://scopeblog.stanford.edu/2015/10/26/a-new-tool-to-treat-atrial-fibrillation/)