What Arthritis Patients Should Know About Stroke and Atrial Fibrillation

June 11, 2012
Daily Health News
Jesper Lindhardsen, MD

If you have rheumatoid arthritis (RA), you’re probably most concerned about managing joint pain.

But the disease can have more serious, life-threatening adverse effects that don’t always have symptoms, so it’s an insidious killer.

Prior studies have shown a link between RA and stroke, and a new study out of Denmark says that those with RA are at risk for yet another serious heart condition—a heart rhythm disorder called atrial fibrillation.


The study looked at the health records of the entire Danish population (about four million people), including Danes who had been diagnosed with RA and were taking RA drugs.

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Researchers wanted to compare that group to the general population to see who had atrial fibrillation or a stroke during the five-year study period.

Here is what they found: The RA patients were, on average, 40% more likely to have atrial fibrillation than the general population. Futhermore, all RA patients (whether they had atrial fibrillation or not) were, on average, 30% more likely to have a stroke than the general population.

Stroke can, of course, sometimes cause death, paralysis and other serious complications, and atrial fibrillation can also have severe consequences, including stroke and heart failure.

One limitation of the study is that it did not consider whether the medications that these patients were on might be somewhat or fully responsible for the increased incidence of atrial fibrillation or stroke. But when I spoke with the study’s lead author, Jesper Lindhardsen, MD, research fellow and physician in the department of cardiology at Copenhagen University Hospital, he pointed out that RA is a disease that causes inflammation of all of the body’s systems—not just the joints—and that inflammation is what’s thought to lead to atrial fibrillation and stroke.


Stroke, of course, usually has symptoms—and they’re often quite obvious (including sudden loss of balance, inability to speak or slurred speech, paralysis or numbness on one side of the body, blurred vision or severe headache).

Atrial fibrillation, on the other hand, sometimes has symptoms and sometimes does not. And when it does, the symptoms can be subtle. So if you have RA, said Dr. Lindhardsen, it’s important that you be on the lookout for the following red flags that may indicate atrial fibrillation…

  • Palpitations or a sudden pounding, fluttering or racing sensation the chest—often described as “butterflies”
  • Irregular pulse
  • Intermittent lightheadedness or dizziness

Since atrial fibrillation can be symptomless, if you have RA it’s also wise to ask your doctor to check your heart for atrial fibrillation at your annual checkup. This check would include an assessment of your heartbeat and —if deemed necessary—an electrocardiogram or ECG.

If atrial fibrillation is detected, your treatment will depend on the severity of the problem. Some fibrillation is constant, while some is intermittent. Your doctor will help you decide whether you should be treated with an antiarrhythmic, a drug intended to make the heartbeat even, or with other medicine designed to slow the heart rate. Your doctor might also prescribe an anticoagulant to prevent the blood clots that often result from atrial fibrillation. A naturopathic physician might also try to solve the underlying problem of atrial fibrillation by administering L-carnitine (an amino acid), by ensuring that adequate calcium and magnesium are delivered to the heart and/or by providing omega-3 oils and polyphenolic plant extract.