Women and stroke risk
The American Heart Association recently published a study in its journal Stroke revealing that women with AFib may be at higher risk of stroke than men. Not only that, but they also may have more severe strokes. The researchers examined data from an Austrian stroke registry in which a third of patients had AFib. The stroke strength was rated on a scale of 1 to 10. Women’s strokes averaged a 9 while men’s strokes averaged at a 6 on the scale.
What does this mean for women? The researchers concluded that stroke prevention for women with AFib is extremely important. Women should focus on lifestyle changes to help with conditions that may contribute to stroke. These include losing weight and taking blood-thinning medications to prevent clots.
Women and complications
Women may also be at a greater risk of having complications from a common procedure used to treat AFib. In a study published in JACC: Clinical Electrophysiology, researchers examined over 20,000 AFib patients who were having catheter ablations. A third of these patients were women who were also generally older with higher risk of stroke than the men. After the procedure, the women were 12 percent more likely to wind up in the hospital again within a year.
On the flip side, the study found that women respond well to ablation. They are 8 percent less likely to need another ablation to treat their AFib. They are also 25 percent less likely to need cardioversion, another treatment performed to try to restore a regular heart rhythm. So, while women did seem to have a greater risk of complications in the year after ablation, they may fare well in the long term.
Yoga and AFib
Striking a yoga pose may have the power to both lower your blood pressure and slow heart rate. In an article published by the European Journal of Cardiovascular Nursing, researchers assigned 80 AFib patients either standard treatment or standard treatment plus yoga. At the end of the study, these people filled out questionnaires about their health. In addition to experiencing physical benefits, participants who did yoga had higher mental health scores and reported a higher quality of life.
If you’d like to incorporate yoga into your routine, ask around at local studios to see what forms they teach. The participants in this study did what is called MediYoga, which is specifically designed for people with heart conditions. If you can’t find a class in this method, a local teacher may be able to modify their class to suit your needs.
Nearly one in three people with AFib aren’t taking the recommended blood thinners to reduce their stroke risk. Researchers recently published an article in the Journal of the American College of Cardiology about how the paradigm for AFib treatment may be changing. While blood thinners should be recommended to all the people in this study, only between 60 and 62 percent of them were taking warfarin or other blood thinners. Another 38 to 40 percent of people were taking just aspirin.
Even more worrying, the gap of care seems to be the greatest in people who are at higher risk of having complications, like people with high blood pressure and heart disease. The researchers recommend that people with AFib who can take blood thinners take more than just aspirin. If you’re currently not taking a blood thinner, consider speaking with your doctor about this treatment option to lower your risk of stroke.
Newer and developing treatments
You may be well aware of the new, shorter-acting anticoagulants available as alternatives to traditional warfarin (Coumadin). These drugs — rivaroxaban (Xarelto), apixaban (Eliquis), and dabigatran (Pradaxa) — are suitable for people with nonvalvular AFib. They require far less frequent monitoring than warfarin and may even lead to less bleeding inside the skull. They also have far fewer drug and food interactions.
You may have heard about the new procedures that might prevent stroke. Devices such as the WATCHMAN and LARIAT can be placed to block off your left atrial appendage, which is where blood pools and forms clots that can lead to stroke.
Antiplatelet agents such as clopidogrel (Plavix) may reduce blood clotting in people who can’t take warfarin. This drug is currently given to people to prevent sudden or unpredictable blood clotting and other issues related to heart attack. A recent study revealed that people who took both clopidogrel and aspirin (Bufferin) significantly reduced their stroke risk. At the same time, this combination of therapies did increase major bleeding, making current blood-thinning drugs a better choice for now.
Alternative treatments ranging from targeting AFib itself to controlling heart rhythm to preventing blood clots from reaching the brain are also in development. For example, a drug called dronedarone (Multaq) may target heart rate and rhythm. In early research, this drug has possibly reduced death and hospitalization with heart events compared to placebo treatment.
Making treatment individual to each person’s DNA is yet another area researchers are exploring. Phenotyping people with AFib is the topic of a recent article published by the Journal of Internal Medicine. “Phenotype” is a term used to describe characteristics resulting from both genetic background and environment. Once a person’s unique phenotype is determined, researchers propose tailoring treatment by including choices between rate or rhythm control, different medications and procedures, and management of different conditions the person has. By using this method, researchers believe people with AFib can have better outcomes with fewer side effects and other negative events.
The takeaway: Keep yourself informed
Doctors and researchers are discovering new things every day to help you live a better life with AFib. If you feel out of the loop, try making an appointment with your doctor to discuss any new developments in the field of AFib research. You can also check ClinicalTrials.gov to find out if there are any studies happening in your area.