Although InsideSurgery is not treating John Fettterman, today he released a statement that he had suffered and is recovering for a stroke today.
He reported that his stroke was due to having atrial fibrillation or also known as A-fib. This is a condition where the top two heart chambers (the atria) beat in an irregular rhythm. Medical students are taught to diagnose the condition by feeling for a pulse and noting a heart beat that is “irregularly irregular. The condition is most commonly seen in patients as they age, but can occur as a genetic condition in younger patients.
Atrial fibrillation can be treated with a procedure called cardioversion. This is done by placing the patient under sedation and shocking the heart back into rhythm. This is most successful when the condition is newly developed
Atrial fibrillation by itself is generally not life-threatening. However, a fib greatly increases the risk of stroke if not treated correctly. This occurs because the irregularly beating atria do not pump blood through to the ventricles in synchrony with the pumping of the ventricles either out to the lungs or to the body through the aorta. This causes a pool of blood in the atria, which then can then form clots. If a clot in the left atria breaks loose, it can travel up the carotid artery to the brain, wedging in a brain artery, causing an obstruction and a resulting ischemic stroke.
With the advent of modern stroke care, the goal is to resolve the clot within three hours of start of symptoms. This is done by administering “clot-busting’ drugs into body to dissolve the clot. If done soon enough after the stroke, any brain tissue at risk of dying through lack of oxygen and glucose from a lack of blood supply can be saved and full-recovery is possible. Generally patients stay in the hospital to watch for secondary clots being thrown off the heart clot and to thin the blood on a chronic basis. This is done with a lower dose of the lysis drugs used on the brain clot and then heparin and coumadin or another anti-coagulant.
A correct initial treatment of a fib if cardioversion is not an option is to chronically thin the blood and prevent the heart clots from forming the in the first place. For many decades, this was done by a daily dose of coumadin but newer drugs like Pradaxa, Eliquis, and Xarelto are now replacing coumadin. All the above drugs have the risk of causing abnormal bleeding
President Joe Biden has atrial fibrillation and is on a chronic dose of Eliquis to reduce the five times greater risk of ischemic stroke seen in patients with the condition who are not treated with anticoagulation.
There are some reports in the literature that the use of CoQ-10 supplementation may reduce the lifetime risk of developing a fib.