Heart rhythm disorder: About one in four strokes is due to atrial fibrillation


Atrial fibrillation often goes unnoticed: increased risk of stroke

Atrial fibrillation often manifests itself as palpitations or heart palpitations. But only about half of those affected experience symptoms. The cardiac arrhythmia therefore often goes unnoticed. However, treatment is important to reduce the risk of stroke.

Every year, more than a quarter of a million people in Germany suffer a stroke. Most of these cerebral infarctions are caused by diseases of the blood vessels or the cardiovascular system. Among other things, atrial fibrillation significantly increases the risk of stroke. However, the cardiac arrhythmia remains unnoticed in many sufferers.

Only half of those affected experience symptoms

As the German Heart Foundation writes in a recent press release, strokes often affect people with atrial fibrillation who are unaware of their cardiac arrhythmia and thus have not received the protective therapy.

About a quarter of strokes in this country are caused by atrial fibrillation. In only about 50 percent of the approximately 1.8 million patients with atrial fibrillation does the cardiac arrhythmia make itself felt with noticeable symptoms such as heart palpitations and heartbeat up to the neck, a feeling of pressure in the chest, anxiety, shortness of breath, dizziness and poor performance.

In the other half, atrial fibrillation usually occurs only atypically or even without any symptoms at all. “Stroke is the greatest danger posed by atrial fibrillation. Especially older patients over 60 years of age, with a cluster of cardiovascular diseases such as high blood pressure, diabetes and coronary heart disease, have a high risk of developing atrial fibrillation and should protect themselves,” says heart specialist Priv.-Doz. Dr. med. Gerian Grönefeld of the Scientific Advisory Board of the German Heart Foundation.

That’s why the foundation recommends that older people over 60 and those with heart disease also take their pulse regularly. “If the pulse is irregular or is above 100 beats per minute at rest, you should see a doctor immediately to have it clarified whether atrial fibrillation is present,” says Grönefeld.

Recognizing stroke signs and getting help

Strokes don’t always come out of the blue. Individual symptoms often appear days or weeks beforehand, but disappear again after a few minutes. In most cases, these “harbingers” are almost the same symptoms as in a stroke.

Unlike a “real” stroke, these warning signals, called “transitory ischemic attack” (TIA), disappear again after a short time. A TIA, like a stroke, manifests itself through the following symptoms, which everyone should be familiar with:

  • Paralysis symptoms on one side of the body: for example, paralysis of an arm or leg
  • Facial symptoms: drooping corner of the mouth, difficulty smiling
  • Speech disorders: sudden slurred or unclear speech, word-finding problems, incorrect sentence formation
  • sudden severe headaches
  • visual disturbances up to blindness or dizziness

Anyone who notices any of these symptoms should not hesitate, but immediately dial 112. Because the most important thing is not to lose any time.

Treat the underlying disease consistently

The most important first measure after the diagnosis of atrial fibrillation is treatment with an anticoagulant medication (so-called “blood thinners”).

Blood clots can form in the heart, in a bulge in the atrium, due to the irregular heartbeat in atrial fibrillation. If these are washed out and enter the head with the bloodstream, they can block a cerebral vessel: a stroke occurs.

But other cardiovascular diseases that can cause atrial fibrillation must also be taken into account for risk prevention. Therefore, in addition to taking anticoagulant medication, it is equally important to consistently treat the underlying disease of the cardiac arrhythmia.

In addition to high blood pressure, these include in particular coronary heart disease (CHD), valvular heart disease, cardiac insufficiency, myocarditis (inflammation of the heart muscle), diabetes, thyroid disease, COPD (chronic obstructive pulmonary disease) and obesity/overweight.

High blood pressure increases the risk of stroke

High blood pressure is present in about 60 percent of people with atrial fibrillation. Dilatation of the left atrium is the first sign that the heart has already been damaged by high blood pressure.

Patients with high blood pressure should therefore have good therapeutic control to minimize their risk of stroke. For example, lowering the upper value of high blood pressure by just ten mmHg can reduce the risk of stroke by almost 40 percent.

“Patients with hypertension and atrial fibrillation have a dual burden: On the one hand, high blood pressure itself increases the risk of heart attack and stroke due to vascular stress; on the other hand, atrial fibrillation poses the risk of blood clots forming, which in turn can trigger a stroke,” Grönefeld explains.

Reducing the risk

People with cardiovascular disease and healthy people over 60 should take their pulse at home. In this way, they can reduce their risk of stroke. Blood pressure monitors usually also show irregularities in the pulse or you can feel your pulse yourself.

“Doctors should also always feel the pulse first when visiting the doctor’s office, especially for hypertension and heart patients, and take an ECG if anything is abnormal.” So-called “wearables” or “smartwatches” with pulse measurement and ECG functions or apps for smartphones with these functions can also be a help.

However, the ECG documentation of the wearables should be assessed by the doctor in order to make the correct diagnosis.


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