Every year, nearly 800,000 people in the United States have a stroke. About 87 percent of all strokes are 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.
Atrial fibrillation, or A-Fib, which causes 15 percent to 20 percent of ischemic strokes, is the abnormal, irregular beating in the atria, the upper chambers of the heart. This irregular beating doesn’t allow blood to flow as well as it should from the atria to the lower chambers of the heart. This poor blood flow in certain parts of the atrium is what causes blood clots to form and results in strokes.
To prevent these blood clots from forming, patients are often placed on anticoagulation medications, also known as blood thinners. The oldest and most common blood thinner is warfarin, also known as Coumadin. It has been used since the 1950s for multiple reasons over the years. Warfarin has the ability to thin the blood but requires multiple trips to a physician’s office for frequent blood checks to determine how thin the person's blood is. An individual taking warfarin also has dietary restrictions.
In 2010, the first new oral agent was approved for atrial fibrillation stroke prevention. Since then, multiple new agents have been developed. These new agents, which go by brand names such as Pradaxa®, Eliquis®, Xarelto® and Savaysa®, have allowed for more convenient dosing regiments.
These medications are either taken once or twice a day, do not require weekly blood monitoring and have no dietary restrictions. Many of these medications have shown to be safer and more effective then warfarin.
The other options in atrial fibrillation stroke prevention are new mechanical devices that are placed into the left atrium of the heart where blood clots form. They are used to prevent blood clots from leaving the heart and going to the brain. Currently these mechanical devices are being used in people who cannot take blood thinners.
Heart centers throughout the region offer options for stroke prevention. Ask your physician if one of the new medications or mechanical agents is an option for you.
Dr. Craig McCotter, a cardiologist/electrophysiologist with Baptist Health Medical Group Lexington Cardiology, practices at Baptist Health Lexington.