CardioSmart | Atrial Fibrillation



Atrial Fibrillation Led to Stroke: One Man's Story

Brian Kavanaugh suffered a stroke at only 41 because of afib, and began a journey to get his speech back.

By Dennis Thompson Jr., HealthDay News

Medically Reviewed by Niya Jones, MD, MPH

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Irregular heart rhythm can cause a stroke.
Irregular heart rhythm can cause a stroke.

Brian Kavanaugh, a Dallas-based engineer with a defense contractor, started feeling his heart race and flutter when he was in his mid-thirties. His doctors told him not to worry, and said that he had tachycardia, a condition that causes a rapid heartbeat.

They were wrong.

He actually had atrial fibrillation, and the heart condition ultimately caused him to become a stroke victim at age 41. Because of the stroke, he lost much of his language ability and part of his ability to see on the right side of his visual field.

“I still struggle with my speech, and I notice every day that I'm different — and it's difficult sometimes,” said Kavanaugh. “But I've learned enough techniques that a casual observer wouldn't know I have speech problems.”

Recognizing Atrial Fibrillation

Back when Kavanaugh thought he had tachycardia, he noticed his heart beating rapidly more often and his symptoms growing worse. "It felt like skipped beats and a really big thumping in my chest," he recalled. "When I was exercising, a couple of times I would start to gray out a bit."

Kavanaugh decided to undergo ablation for the tachycardia. Ablation is a procedure in which a heart surgeon deliberately scars portions of the heart to halt the errant electrical impulses that cause an irregular heartbeat.

"While I was on the table, they realized: ‘Whoops, he doesn't have tachycardia. He has afib,’" Kavanaugh recalled. "They woke me up and said, 'You have afib and there's no surgical procedure for it.'"

Though it's now performed for afib, ablation wasn't a known treatment for the condition back then.

RELATED: Takes A Licking, Keeps On Ticking: 5 Heart Health Tips From an Electrophysiologist

Kavanaugh started taking a medication to control his heart rate, which he said worked fine at first. "But then after a few years more, it started getting worse and worse," he said. "I upped the dosage and it was still getting worse."

With atrial fibrillation, the upper chambers of the heart — the atria — begin beating rapidly and irregularly. And this is a major risk factor for stroke. In fact, people with atrial fibrillation are five times more likely to have a stroke, according to the National Stroke Association.

"The blood pools in the atria and can stagnate and clot, and those clots can break off and go to your brain, causing a stroke," explained Hugh Calkins, MD, an electrophysiologist. Dr. Calkins is president of the Heart Rhythm Society, and director of the Clinical Electrophysiology Laboratory, the Arrhythmia Service, and the Arrhythmogenic Right Ventricular Dysplasia Program at Johns Hopkins Hospital in Baltimore.

If you have atrial fibrillation, you are five times more likely to have a stroke.

Kavanaugh had his stroke in 1999, during a business trip to Huntsville, Ala. He was at a restaurant reading a newspaper when he realized that he couldn't understand any of the words on the page. "I thought, ‘I must be tired because this isn't making any sense,’" he said.

A waitress seemed to appear out of nowhere. Kavanaugh later realized that the stroke had affected the right side of his visual field and that she must have approached him from that direction. "She started saying something and I responded, and she looked at me like I was from Mars because what I said didn't make any sense," he recalled.

Kavanaugh went out to his car and sat for about a half-hour, but he found that things weren't improving. He walked to the roadside and flagged down a passing police car for help, but by then he couldn't communicate.

The officer mistakenly administered a breath test for alcohol, Kavanaugh recalled. "After a few minutes he figured out it was a medical problem and called the paramedics," Kavanaugh said. "I had zero language at that point. I couldn't say a single word except ‘help.’"

The Long Road to Stroke Recovery

Kavanaugh spent a week in a hospital in Alabama and another week in a Dallas hospital. Then he began the long, painful road to recovery.

He started on speech therapy and began taking an amphetamine derivative every other day to stimulate his speech production.

"I went back to work five or six months after the stroke, which was way too early," he said. "I wasn't very verbal even then, but I had a lot of cheat sheets. I had notes on Post-its that would remind me how to structure a sentence."

He continues to have problems seeing on his right side, but he's learned to work around it. "Today I only notice the diminished vision if I consciously think about it," he said. "I have noticed that I automatically compensate. For instance, when I drive, I always look at the brake lights on the right side of the car that I am following, not on the left brake light. If I look at the left brake light, I don't see much of the right side of that car in my peripheral vision."

Kavanaugh began taking a second medication to regulate his heart's rhythm as well as a blood thinner to help prevent future strokes. Despite the medications, he found his atrial fibrillation beginning to creep back. "It got to where it was 12 to 15 hours a day, and it really wiped me out," he said. "I was completely exhausted, couldn't concentrate, couldn't work."

So four years ago he underwent ablation, the procedure that doctors hadn't done when they first discovered his atrial fibrillation. In the intervening years, research had found that ablation could help with afib as well as tachycardia.

He's now off the drug that controlled his heart rhythm and has reduced by half his dosage of the drug that controls heart rate.






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Date: 04.12.2018, 17:25 / Views: 34334