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    Atrial Fibrillation and Stroke

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    Celine
    The document discusses the relationship between atrial fibrillation and stroke. It explores atrial fibrillation as a cause of stroke, stroke as a potential cause of atrial fibrillation, and other factors associated with atrial fibrillation that can also cause stroke. The document proposes an updated model to explain the mechanisms of stroke in the context of atrial fibrillation.

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    © All Rights Reserved
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    Atrial Fibrillation and Stroke

    Uploaded by

    Celine
    26 views12 pages
    The document discusses the relationship between atrial fibrillation and stroke. It explores atrial fibrillation as a cause of stroke, stroke as a potential cause of atrial fibrillation, and other factors associated with atrial fibrillation that can also cause stroke. The document proposes an updated model to explain the mechanisms of stroke in the context of atrial fibrillation.

    Original Description:

    Hubungan Stroke dengan Atrial Fibrilasi

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    The document discusses the relationship between atrial fibrillation and stroke. It explores atrial fibrillation as a cause of stroke, stroke as a potential cause of atrial fibrillation, and other factors associated with atrial fibrillation that can also cause stroke. The document proposes an updated model to explain the mechanisms of stroke in the context of atrial fibrillation.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    26 views12 pages

    Atrial Fibrillation and Stroke

    Uploaded by

    Celine
    The document discusses the relationship between atrial fibrillation and stroke. It explores atrial fibrillation as a cause of stroke, stroke as a potential cause of atrial fibrillation, and other factors associated with atrial fibrillation that can also cause stroke. The document proposes an updated model to explain the mechanisms of stroke in the context of atrial fibrillation.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    You are on page 1of 12

    Association Between Atrial

    Fibrillation and Stroke


    Preceptor : dr. Martin Firman Suryo, Sp.S, FIPM
    Clinical Clerkship Neurology Rotation
    Royal Taruma Hospital
    by Celine 406162058 Period of 26 November – 30 December 2018
    Association Between
    Atrial Fibrillation and Stroke
    A. Atrial Fibrillation as a Cause of Stroke
    B. Stroke as a Cause of Atrial Fibrillation
    C. AF is associated with other factors that cause stroke

    Kamel H, Okin PM, Elkind MSV, Iadecola C. American Heart Association. Atrial Fibrillation and Mechanisms of
    Stroke Time for a New Model. In: Stroke. 2016;47:895-900.
    by Celine 406162058
    Atrial Fibrillation and Stroke

    • Atrial fibrillation (AF) is the most common cardiac arrhythmia and is


    associated with a 3-5 fold increase in the risk for stroke (after adjustments
    of other risk factors)
    • Century old hypothesis  fibrillation of the atrium produces stasis of
    blood, which causes thrombus formation and embolism to the brain

    Kamel H, Okin PM, Elkind MSV, Iadecola C. American Heart Association. Atrial Fibrillation and Mechanisms of
    Stroke Time for a New Model. In: Stroke. 2016;47:895-900.

    by Celine 406162058
    Centuries Believed Hypothesis

    by Celine 406162058
    However…
    • Recent work suggests that the pathogenesis of stroke in AF is more
    complicated and involves multiple factors in addition to the dysrhythmia
    • If AF causes thromboembolism, it should be specifically associated with
    embolic strokes
    • There does appear to be an especially strong association between AF and
    embolic strokes
    • The link between AF and non-cardioembolic stroke indicates that stroke risk
    in AF cannot be entirely explained by AF directly causing stroke
    by Celine 406162058

    Kamel H, Okin PM, Elkind MSV, Iadecola C. American Heart Association. Atrial Fibrillation and Mechanisms of Stroke Time for a New Model. In:
    Stroke. 2016;47:895-900.
    Association Between
    Atrial Fibrillation and Stroke
    A. Atrial Fibrillation as a Cause of Stroke
    B. Stroke as a Cause of Atrial Fibrillation
    C. AF is associated with other factors that cause stroke

    Kamel H, Okin PM, Elkind MSV, Iadecola C. American Heart Association. Atrial Fibrillation and Mechanisms of
    Stroke Time for a New Model. In: Stroke. 2016;47:895-900.
    by Celine 406162058
    Stroke as a Cause of AF
    • Hypothesis :
    • Central nervous system injuries  autonomic nervous system  plays important role
    in the pathogenesis of AF
    • Stroke  necrotic cell death from  activates a systemic inflammatory response 
    plays a role in the origin of AF

    Kamel H, Okin PM, Elkind MSV, Iadecola C. American Heart Association. Atrial Fibrillation and Mechanisms of
    Stroke Time for a New Model. In: Stroke. 2016;47:895-900.
    by Celine 406162058
    AF-Associated Factors as Causes of Stroke
    Structural remodelling
    AF
    seems to require weeks of
    AF, not just the 6 minutes
    that suffice to signify an
    increased stroke risk

    Atrial
    Stroke
    Abnormalities
    Homozygous mutation of the
    natriuretic peptide precursor A
    gene. Even though AF is absent,
    this disorder leads to atrial
    by Celine 406162058 dilatation, progressive loss of atrial
    activity with eventual atrial
    Kamel H, Okin PM, Elkind MSV, Iadecola C. American Heart Association. Atrial Fibrillation
    and Mechanisms of Stroke Time for a New Model. In: Stroke. 2016;47:895-900.
    standstill, and thromboembolism
    Association Between
    Atrial Fibrillation and Stroke
    Atrial Fibrillation as a Cause of Stroke

    Stroke as a Cause of Atrial Fibrillation

    AF is associated with other factors that cause stroke

    Updated Model for the


    Mechanisms of Stroke in AF

    Kamel H, Okin PM, Elkind MSV, Iadecola C. American Heart Association. Atrial Fibrillation and Mechanisms of
    Stroke Time for a New Model. In: Stroke. 2016;47:895-900.
    by Celine 406162058
    Updated Model for the
    Mechanisms of Stroke in AF

    by Celine 406162058

    Kamel H, Okin PM, Elkind MSV, Iadecola C. American Heart Association. Atrial Fibrillation and Mechanisms of Stroke Time for a New Model. In:
    Stroke. 2016;47:895-900.
    • Atrial fibrillation leads to changes in atrial size, predisposing to thrombus formation, and further endothelial damage,
    myocytic hypertrophy, necrosis, and mononuclear cell infiltrates leading to a hypercoagulable state. Diabetes is a state of
    inflammation where platelet and fibrinogen activation also contribute to thrombus formation. These changes in blood flow,
    vessel wall, and blood components fulfill the criteria of Virchow’s triad of thrombogenesis.

    by Celine 406162058

    Plitt A, McGuire DK, Giugliano RP. Atrial Fibrillation, Type 2 Diabetes, and Non–Vitamin K Antagonist Oral Anticoagulants A Review. In: JAMA Cardiology.
    2017;2(4):442-448.
    by Celine 406162058

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