Study says irregular heartbeat may double risk of "silent" strokes

A friend handed me an article from the newspaper this morning, with this title. It stated that 'silent strokes", which occur wiht no signs or symptoms, can affect thinking and memory. "The higher prevalence of silent strokes in patients with atrial fibrillation may put this population at higher risk for mental impairment, future stroke and disability".

Has anyone on here been told they had a silent stroke? How common is this and how would they know you had one?

Finally, if someone has had an ablation and the heart monitor is showing NSR, can they then say they do not have Afib , or once you have it, you always have it, it's just been silenced by an ablation? I never know whether to say I HAVE Afib or I HAD Afib, as to me it's always lurking....

Barb

Hi Barb,

we covered SCI (silent cerebral ischemia) and both AFIB itself as a prime source of these SCIs in a special report in the April/May issue of The AFIB Report. Please go back and read that and related ussue of SCI and AFIB ablation.. By far the biggest source is unaddressed AFIB itself.

Another reason why tolerating still a modest amount of AFIB breakthroughs may wind up being a Faustian bargain long term with the possible increase in dementia that may result from cumulative build up of these SCIs over time... Nearly all invasive cardiac procedures and angiograms also can create SCIs too.

Until very recently all the studies and rules of thumb on long term risks and issues of living with either persistent Silent AFIB or even just periodic moderate breakthroughs of paroxysmal AFIB never accounted for this source of potential side effects from living with AFIB, and thus almost all those old rules of thumb are way outdated and underestimate the true risk in settling for anything but as close to total permanent NSR as you can achieve for yourself, by whatever means can bring you true stable NSR and dramatically reduce your AFIB burden.

Chalk this up for another check mark in the ablation camp as a key step, once a success ablation process is complete, in granting former Afibbers their greatest risk reduction from adding greater cumulative SCI burden in the brain due to accepting anything less than extremely well controlled AFIB/Flutter in their lives.
You've already taken your biggest steps toward lessening any such added SCI burden going forward Barb, so you should not be too concerned or worried.

Shannon



Edited 1 time(s). Last edit at 11/08/2014 05:54AM by Shannon.

Shannon, i need to ask you for a favor and i hope it does not take too much trouble. Please would you show here a link to that issue so i can re-read that article on silent strokes? I have always suspected that such a thing as a silent stroke existed, because when an MRI was done after my small stroke in april 2009, the film showed 2 white marks from 2 separate strokes, so it was said. I was aware of the 2nd one, the one that got me to the hospital, but not of the first.

PeggyM

Barb - The concern is and always has been that other co-existing medical conditions can also contribute to risk of stroke in those who also have Afib. Typically the "lone" designation for Lone Atrial Fibrillation means that there are no other underlying factors that complicate the total health of the patient...such as valve disorders or hypertension.

But, as mentioned in the other recent post on risk of stroke, regardless of whether or not one currently has LAF or is a former (ablated) LAFfer, the key to avoiding the adverse clotting tendency is always to make sure that blood viscosity is in the normal range. That requires periodic monitoring of the Predictive Biomarkers we have discussed in the posts on Thick, sticky blood or hyperviscosity... and that titled Red Flags to Beat the Odds... and includes

Hemoglobin A l c
High Sensitivity C-reactive Protein
Fibrinogen
Ferritin
Homocysteine
Oxidized LDL/HDL
Triglyciderides
Interleukin 6

Or as Shannon mentioned in the other post... the Meridian Valley [meridianvalleylab.com]

And any contributors to silent inflammation such as food sensitivities that provoke reactive antibodies such as IgA, IgM and IgG. And know your vitamin D level via the 25 hydroxy vitamin D test. (25 OH D)... Keep your D levels up in the therapeutic range.[www.lef.org]

We have also often discussed using antiinflammatory nutrients such as Omega 3 fish oils, Vitamin E, curcumin, boswellia, resveratrol, green tea extract, astaxanthin, lycopene and many more including magnesium which offers anti-platelet aggregation properties along with proteolytic and fibrinolytic enzymes such as Nattokinase and Lumbrokinase. Plus... eating lots of fresh, antiinflammatory foods.

If you know your Predictive Biomarkers are in good range and you eat a healthy, 'clean' and the new term is "enlightened diet"... you should not have worries about silent stroke now that your successful ablation is in place. Just keep your blood thin and and platelets slippery.

Be well,
Jackie

PeggyM Wrote:
-------------------------------------------------------
> Shannon, i need to ask you for a favor and i hope
> it does not take too much trouble. Please would
> you show here a link to that issue so i can
> re-read that article on silent strokes? I have
> always suspected that such a thing as a silent
> stroke existed, because when an MRI was done after
> my small stroke in april 2009, the film showed 2
> white marks from 2 separate strokes, so it was
> said. I was aware of the 2nd one, the one that got
> me to the hospital, but not of the first.
>
> PeggyM

Hi Peggy,

PM me your email address and Ill drop you a copy. Access to current and past issues of the AFIB Report is still by subscription and one can access the past reports via a separate username and password after subscribing. But I will send you this copy for your interest.

Cheers!
Shannon

Thanks for your replies here, Shannon and Jackie. I've had a few more thumps and bumps on and off lately as well as a pulse that feels a bit fast (not super fast like Flutter, but in the 90's)...so I have had some concerns about any resurgence of Afib or Flutter....when this article was handed to me, it just added to the concerns... I don't know all of my inflammation markers, Jackie...not sure how much of those my insurance covers, but I know it's important to find out. How often do you feel you need to get those checked - once/year?

I guess I was playing Russian Roulette with my 10 years of Afib...as it had become so frequent...but I had convinced myself I was managing it as I could always get it to stop. And yes, this is another reason to strongly consider an ablation...In my job, .I see patients with dementia every week and it does not look like fun at all..very sad indeed.

Thankfully we all have the knowledge and support on this Board that has helped us figure this all out. Special thanks to you both, Jackie and Shannon - you are our guardian angels

Barb

Barb:

My1/2 brother and his wife both have had mini-strokes, neither have AF or had any problems with their heart. My Brother did have one of his carotid arteries cleaned out after the stroke, he has some weakness in his left arm which has mostly resolved, he also had some problems with his one eye (he was seeing double) he has had an operation on it and he is fine now. His wife didn't seem to be left with any infirmities.

My mother had permanent AF for about 15 years, she did have some high blood pressure but she never had a stroke, she died at age 92. So, we never know do we, I believe that we should get most of the tests which Jackie has recommended, some of the supplements like magnesium, Vit. D., the B vitamins (I believe are very important and not mentioned much) along with some of the others and just enjoy what we have.

Liz

Barb - As for the Predictive Biomarker testing... I have that twice a year... and also more frequently if something shows out of range. If that's the case, then I work on what's needed to normalize and then retest. So far, most of the tests are covered by insurance, but not all. In the long run, paying out of pocket is a minor expense compared to the toll of a stroke or MI. Additionally, my Functional Medicine MD does a metabolic profile test... to assess nutritional status from a functional aspect for all critical system that need to be in balance and harmony.

If possible, it would be most helpful for you to consult with a functional medicine type practitioner to help get your total system in balance now that ablation is behind you. Especially useful would be having the Exatest to learn your intracellular electrolyte status. It's important to keep up with optimizing electrolytes after ablation.

Liz mentions B vitamins. At one time, my NutrEval metabolic profile indicated I was low in methylation components so specific forms and higher than typical dosing of various B's were recommended. Later testing indicated normal functioning.

Each of our body's systems have specific nutritional requirements for proper function and without testing, it's impossible to guess about status. As we age and especially when we are over-stressed continually, we become very prone to stress-related symptoms and eventually, the consequences. Stress depletes magnesium and that's typically what shows up for us with Afib history as heart blips or we forget that sodium overpowers potassium. While the Cardiologists and EPs downplay the importance of nutritional supplements, the science or biophysiology indicates the heart can't function smoothly or efficiently without the proper nutritional fuel.
Always was; always will be.

Try to relax, think good thoughts and do good things for yourself as often as possible, Barb.
I wish you well,
Jackie

Jackie

Barb,
I had two silent strokes or TIA's I never knew about prior to my TIA Labor day weekend 2012 . I only found out about these after my brain MRI/MRA they did after they rushed to the ER that day and the subsequent scan the next day. Marvelous.

McHale

I'm a bit confused on all of these. Is this silent stroke risk still there for paroxysmal fibbers who are on blood thinners?
Thanks,
Nancy

Hi Nancy,

The blood thinners may help reduce SCI creation for paroxysmal AFIB, but like for symptomatic strokes it is not a guaranteed solution but just lowers the odds per year. But over a long time frame the odds of still having some degree of SCI is still there to a degree regardless with drugs. The only sure prevention is sustained NSR, by whatever means it is achieved and AAR drugs are not the best way to insure long term solid NSR.
Shannon



Edited 1 time(s). Last edit at 11/12/2014 03:23PM by Shannon.

In Hans book...and in several posts, he quoted a study that indicated:

"About 50% of all heart attack and stroke victims are actually on warfarin (Coumadin) at the time of their incident according to several clinical trials." … Thrombosis and Stroke Prevention (C2004)

Not sure if there are comparison studies out yet with the NOACs, but as Shannon indicates, the best preventive is NSR.... however, as mentioned earlier, people w/o Afib also have strokes and that comes from overly thick blood and mentioned more than frequently.

Emphasis must be on knowing the Predictive Biomarkers as an effective means of stroke and MI prevention.

Jackie

All very good information. Thanks again, Jackie. The challenge is to find a functional MD...I found a functional Chiropractor, but am not sure if that's the best around here or not. Also recently met a woman who says she is a functional nutritionist and will send out for tests on the adrenals, etc. I would like to have that done..don't know if a "regular doc' will order those kinds of tests... Homework to do.

McHale - how are you doing? Haven't heard from you in awhile..

Good night all ~ Barb

Barb - a functional nutritionist should be able to help with the test results and often works with an MD practitioner so that's one way of backing into functional medicine care.

I hope you can follow through with that lead.

Jackie

Hi Barb,
I'm living Life or rather working my butt off between my day job in IT and my running my small business for 37 years now and taking care of my ailing MOM. For what reason I do this and stress myself out is a mystery to me as it's not like I need to put kids thru college or sustain an extravagant lifestyle. I'm just old school maybe a psychotic workaholic.....and squeeze in three workouts a week of for a total of 6-7 hours. I will always take care of my dear mom till she heads out to join my dad.
Anyway I'm fine, no AFIB, at all, just had a good stress test too! HR hit 160bpm after 9.5 mins of exercise
Did go see a Broadway Play Love Letters yesterday with someone I met on my 58th Birthday Saturday evening.........
Life is good when you don't worry about AFIB. All those triggers are gone, Alcohol, Workouts,Smiling, Walking, Eating, Breathing etc....and for no reason at all. Heart has really calmed down now for good at almost 18 months.

McHale



Edited 2 time(s). Last edit at 11/18/2014 04:38AM by McHale.