RECENT research has suggested that people who once had an irregular heart beat should continue to stay on medication to prevent stroke, even if their heart beat is no longer irregular. The authors advise that the risk of stroke and death is still higher than in those who never had this irregular heart rhythm, referred to as Atrial Fibrillation (AF).

However part of the treatment of AF involves blood thinning drugs, which pose risks for bleeds in the stomach and brain.

AF is the commonest heart rhythm abnormality, affecting roughly one million individuals in the United Kingdom.

The atria are the top two chambers of the heart. Normally they contract rhythmically to push blood into the bottom two chambers, the ventricles. In AF, the atria do not beat in a controlled manner but wobble like jelly.

The effect is twofold; firstly the system is not as effective and less blood is pumped into the ventricles. Secondly, turbulent blood flow increases the risk of a clot forming in the atria.

If this passes into the left ventricle and out into the circulation, it may lodge in a blood vessel supplying the brain, resulting in stroke, sometimes with devastating consequences.

AF may not have any symptoms whatsoever, however it may present with palpitations, which can come or go.

Sometimes the heart rate becomes very fast and because less blood gets into the ventricles, you may notice breathlessness or dizziness. If you notice any of these, please seek urgent medical help.

THE first thing a medical professional will do is check your pulse, either in the wrist or sometimes in the neck. An electrocardiograph (ECG) will give a read out of the heart rhythm.

In some people, AF comes and goes, so if nothing is captured on a standard 30 second trace, you may be referred for a 24 hour ECG.

Basic treatment involves medication to control the heart rate, and drugs to reduce the chance of a clot. Previously the only option was warfarin.

Newer drugs called NOACS are now available, which do not need the regular blood tests needed for warfarin monitoring.

Some people will be suitable for cardioversion, which is similar to restarting a heart which has stopped. Another option is to try and burn the sources of the irregular heart beat in the atria, by a catheter passed through the blood vessel in the groin.

Although these last two are seen as a cure, patients may still go back into AF thereafter.

So the question of how safe you are to stop your warfarin or NOAC if you are no longer in AF remains. It should be remembered that AF is not the only risk factor for stroke and that the study did not prove that previously having AF was the cause of stroke. If you are in a quandary it would be worth discussing it with your GP who will help you to weigh up the risks and benefits of any treatment decisions.