Take warning to heart

An estimated quarter of a million Canadians have a type of irregular heartbeat that dramatically increases their risk of having a potentially fatal stroke — but many are not getting the treatment they need, says the Heart and Stroke Foundation.

A stroke can occur during atrial fibrillation.

TORONTO — An estimated quarter of a million Canadians have a type of irregular heartbeat that dramatically increases their risk of having a potentially fatal stroke — but many are not getting the treatment they need, says the Heart and Stroke Foundation.

The foundation says people with atrial fibrillation are five times more likely to have a stroke and twice as likely to die from it.

Yet many of these patients are unaware of their risk and are not receiving blood-thinning medications that significantly reduce the risk of stroke, says Dr. Marco Di Buono, director of research for Heart and Stroke Ontario.

“This is particularly worrisome because living with the effects of stroke for someone with atrial fibrillation is more severe than living with the effects of stroke for someone who doesn’t have underlying atrial fibrillation,” Di Buono said.

Patients with the heart rhythm disorder are in hospital longer after a stroke and are often left with more severe physical and cognitive disabilities, he explained. “So their ability to reintegrate into their families, into their communities, into the workforce is much more hampered than an individual who doesn’t have A fib.”

“And they’re likely to have recurrent strokes. So that’s a very important piece to highlight because with every recurrent stroke, the chance of mortality increases significantly.”

While rare in people under 40, the risk of developing atrial fibrillation increases with age. After 55, its incidence doubles with each decade of life and with such risk factors as high blood pressure, diabetes and underlying heart disease.

“Up to 15 per cent of strokes are caused by AF,” said cardiologist Dr. Paul Dorian, a foundation spokesman. “In people over the age of 60, that number increases to about one-third of strokes.”

Atrial fibrillation is the most common form of heart rhythm disturbance and is linked to abnormal changes in electrical signals controlling the heart’s pumping action. The condition, which is marked by irregular and/or rapid heart beat, causes blood to pool in the heart — allowing clots to form that can travel to the brain.

“The clots are fairly large in these circumstances and that’s why the outcomes of atrial fibrillation-related stroke are (believed to be) much more severe,” said Di Buono.

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