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What Will Be The Risk Of Stroke Or Clot Formation With Atrium ?

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Posted on 5 days ago
Question: What happens to an atrium that flutters or fibrilate 6 times every RR interval and 180 times in a minute, what happens to said atrium when a pacemaker is implanted in the ventricle so that the ventricle goes from contracting 30 times per minute to 60 times per minute?
How will this atrium act once the pacemaker has been implanted? Will it flutter, flap or fibrillate 6x6 = 360 times per minute?
What will then be the risk of stroke or clot formation?
Thanks
doctor
Answered by Dr. Ilir Sharka (1 hour later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello,

Regarding your questions let me explain as follows:

When the atrial chamber flutters or fibrillates frequently, it will gradually undergo structural changes leading to subsequent fibrosis and dilatation.

From the other side a ventricular implanted pacemaker will correct the insufficient ventricular heart rate, but will not affect the occurrence of atrial arrhythmia (atrial fibrillation or flutter).

So, atrial flutter/fibrillation will continue to exert their effect on atrial chambers an the risk of stroke will not be decreased. That's why anti-coagulation for stroke prevention should be applied regularly.

Hope to have clarified your issues of concern.

Let me know in case of any further questions.

Kind regards,

Dr. Ilir Sharka
cardiologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome to - Ask a Doctor - service!

Regarding your questions let me explain as follows:

When the atrial chamber flutters or fibrillates frequently, it will gradually undergo structural changes leading to subsequent fibrosis and dilatation.

From the other side a ventricular implanted pacemaker will correct the insufficient ventricular heart rate, but will not affect the occurrence of atrial arrhythmia (atrial fibrillation or flutter).

So, atrial flutter/fibrillation will continue to exert their effect on atrial chambers an the risk of stroke will not be decreased. That's why anti-coagulation for stroke prevention should be applied regularly.

Hope to have clarified your issues of concern.

Let me know in case of any further questions.

Kind regards,

Dr. Ilir Sharka
cardiologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka (2 hours later)
Can the atrial bradyarrhythmia, flutter in my case, become
atrial tachyarrhythmia, due to pacemaker implantation?

What are the chances of that happening ?

Thank you so much.
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Follow up: Dr. Ilir Sharka (0 minute later)
Can the atrial bradyarrhythmia, flutter in my case, become
atrial tachyarrhythmia, due to pacemaker implantation?

What are the chances of that happening ?

Thank you so much.
doctor
Answered by Dr. Ilir Sharka (19 hours later)
Brief Answer:
I would explain:

Detailed Answer:
Hello again!

Let me explain that pacemaker may predispose to a higher incidence of atrial arrhythmia (premature atrial contraction, atrial fibrillation, etc.)

Anyways, in your case there is no scientific evidence of higher incidence that after pacemaker implantation atrial bradyarrhythmia could be replaced by atrial tachyarrhythmia.

Hope to have clarified your issue of concern.

Greetings,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Prasad
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I would explain:

Detailed Answer:
Hello again!

Let me explain that pacemaker may predispose to a higher incidence of atrial arrhythmia (premature atrial contraction, atrial fibrillation, etc.)

Anyways, in your case there is no scientific evidence of higher incidence that after pacemaker implantation atrial bradyarrhythmia could be replaced by atrial tachyarrhythmia.

Hope to have clarified your issue of concern.

Greetings,

Dr. Iliri


Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Ilir Sharka (1 hour later)

Dear Dr. Iliri,

My heart rate is 33 bpm during the day and 22-27 bpm at night during the
early morning hours prior to awakening.
My left ventricular outflow tract (LVOT) velocity time integral (VTI)
is between 20 cm and 25 cm.
My LVOT diameter is between 2 cm and 2.4 cm.
Stroke Volume is between 62.83 and 113.10 ml
Cardiac Output is between 2.07 and 3.73 L/m
ECG findings are:
Atrial Flutter, 180 fluttering waves per minute
Atrio Ventricular Block undetermined type.
QRS width 0.16 sec.
Left Bundle Branch Block.

Questions:
Why I do not have symptoms with this very very low cardiac output?
What kind of physiological adaptation of the cardiovascular system
is happening here?

Thank you so much for your help.

Jesus Devesa
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Follow up: Dr. Ilir Sharka (0 minute later)

Dear Dr. Iliri,

My heart rate is 33 bpm during the day and 22-27 bpm at night during the
early morning hours prior to awakening.
My left ventricular outflow tract (LVOT) velocity time integral (VTI)
is between 20 cm and 25 cm.
My LVOT diameter is between 2 cm and 2.4 cm.
Stroke Volume is between 62.83 and 113.10 ml
Cardiac Output is between 2.07 and 3.73 L/m
ECG findings are:
Atrial Flutter, 180 fluttering waves per minute
Atrio Ventricular Block undetermined type.
QRS width 0.16 sec.
Left Bundle Branch Block.

Questions:
Why I do not have symptoms with this very very low cardiac output?
What kind of physiological adaptation of the cardiovascular system
is happening here?

Thank you so much for your help.

Jesus Devesa
doctor
Answered by Dr. Ilir Sharka (19 hours later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

You are right about low cardiac output and absence of clinical symptomatology.

But, from the other side heart failure is considered a clinical syndrome, not always correlating with cardiac output.

Anyways, your stroke volume is within normal ranges and the problem stands upon low heart rate.

In order to correctly answer your second question, it is necessary to review heart rate during physical exertion. Holter monitoring test would be helpful in this regard.

Could you upload your Holter monitoring test here for a second professional opinion, please!

I remain at your disposal for further discussions.

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello again!

You are right about low cardiac output and absence of clinical symptomatology.

But, from the other side heart failure is considered a clinical syndrome, not always correlating with cardiac output.

Anyways, your stroke volume is within normal ranges and the problem stands upon low heart rate.

In order to correctly answer your second question, it is necessary to review heart rate during physical exertion. Holter monitoring test would be helpful in this regard.

Could you upload your Holter monitoring test here for a second professional opinion, please!

I remain at your disposal for further discussions.

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Yogesh D
doctor
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Follow up: Dr. Ilir Sharka (3 hours later)
JFK Medical Center didn't upload the holter monitoring test to my medical records .
After I stopped all sport competition 10 months ago I only go up to
65 beats per minute in the rowing machine.
You can see in the attachment my last ECG and the heart rate during physical exertion last Sunday. But it is not actually exertion it doesn't connotes any strenuous or costly effort
for me. I never try now to go up with the heart rate.

Thank you so much.
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Follow up: Dr. Ilir Sharka (0 minute later)
JFK Medical Center didn't upload the holter monitoring test to my medical records .
After I stopped all sport competition 10 months ago I only go up to
65 beats per minute in the rowing machine.
You can see in the attachment my last ECG and the heart rate during physical exertion last Sunday. But it is not actually exertion it doesn't connotes any strenuous or costly effort
for me. I never try now to go up with the heart rate.

Thank you so much.
doctor
Answered by Dr. Ilir Sharka (18 hours later)
Brief Answer:
Opinion as follows:

Detailed Answer:
Hello again, dear Jesus!

Your uploaded ECGs show atrial arrhythmia (atrial fib/flutter) and bundle branch block. In general individuals engaging in competition sports develop myocardial conditioning and lower average heart rates.

As far as you are asymptomatic, there is no issues of great concern. It is necessary to follow up heart rate and cardiac performance by means of cardiac ultrasound.

In order to differentiate between athlete's heart from any pathological cardiac disorder, cardiac magnetic resonance imaging test would be very helpful.

You could discuss with your attending doctor on these issues.

Hope to have been helpful!

Best regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Ilir Sharka (0 minute later)
Brief Answer:
Opinion as follows:

Detailed Answer:
Hello again, dear Jesus!

Your uploaded ECGs show atrial arrhythmia (atrial fib/flutter) and bundle branch block. In general individuals engaging in competition sports develop myocardial conditioning and lower average heart rates.

As far as you are asymptomatic, there is no issues of great concern. It is necessary to follow up heart rate and cardiac performance by means of cardiac ultrasound.

In order to differentiate between athlete's heart from any pathological cardiac disorder, cardiac magnetic resonance imaging test would be very helpful.

You could discuss with your attending doctor on these issues.

Hope to have been helpful!

Best regards,

Dr. Iliri
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 9541 Questions

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What Will Be The Risk Of Stroke Or Clot Formation With Atrium ?

Brief Answer: I would explain as follows: Detailed Answer: Hello, Regarding your questions let me explain as follows: When the atrial chamber flutters or fibrillates frequently, it will gradually undergo structural changes leading to subsequent fibrosis and dilatation. From the other side a ventricular implanted pacemaker will correct the insufficient ventricular heart rate, but will not affect the occurrence of atrial arrhythmia (atrial fibrillation or flutter). So, atrial flutter/fibrillation will continue to exert their effect on atrial chambers an the risk of stroke will not be decreased. That's why anti-coagulation for stroke prevention should be applied regularly. Hope to have clarified your issues of concern. Let me know in case of any further questions. Kind regards, Dr. Ilir Sharka cardiologist