From the Research
Atrial Fibrillation and Stroke Risk
- Atrial fibrillation (AFib) is associated with a significantly increased risk of stroke, heart failure, myocardial infarction, dementia, chronic kidney disease, and mortality 1.
- The risk of stroke in patients with AFib can be reduced by 60% to 80% with anticoagulation using a vitamin K antagonist or direct oral anticoagulant compared to placebo 1.
- Rhythm control with antiarrhythmic drugs or catheter ablation can also reduce the risk of stroke in select patients with AFib 1, 2.
Use of Muscle Relaxers in AFib Patients
- There is no direct evidence in the provided studies regarding the use of muscle relaxers, such as cyclobenzaprine (Flexeril), in patients with AFib and a history of stroke.
- However, it is essential to consider the overall management of AFib, including lifestyle and risk factor modification, anticoagulation, and rhythm control, to reduce the risk of stroke and other complications 1, 3, 4.
Anticoagulation and Stroke Prevention
- Oral anticoagulation is effective in preventing strokes secondary to AFib, reducing overall stroke numbers by approximately 64% 3.
- The timing of anticoagulation in patients with AFib after acute ischemic stroke is crucial, and there is no consensus on the optimal timing 5.
- However, a meta-analysis found that starting anticoagulation in the early start window (ESW) versus the late start window (LSW) had comparable rates of recurrent ischemic stroke, symptomatic intracranial hemorrhage, mortality, and major bleeding 5.
Holistic Management of AFib
- A holistic or integrated care approach to managing AFib, including stroke prevention, symptom management, and cardiovascular risk optimization, can improve outcomes 4.
- The ABC (Atrial fibrillation Better Care) pathway provides a framework for managing AFib, including avoiding stroke through anticoagulation, better symptom management, and cardiovascular risk optimization 4.