Hello doctor, I have a question about my father. He is a healthy 75 years old, eats healthy, drinks at least two liters water a day. He has since five years atrial fibrillation and gets for that Xarelto 15 mg and Amlodipine accord 5 mg, takes them in the morning and that was always good. Unfortunately, he had a brain stroke on the left part. He walked to the ambulance. On the next day, he had lesser movement on the left side (mouth, arm, leg, and difficulties with swallowing). Yesterday, it was worse and the doctors say he has a stuttering stroke because the situation is going worse. Because of a little fever and the cholesterol too high he gets something for cholesterol and an antibiotic called Ceftriaxone. The doctors think the worse is now over but still little risk next 48 hours. My question is that we see on the monitor every day fewer peaks in his heartbeat. Please see the pictures, the doctors say that is an extra heartbeat and does not matter, his regular heartbeat is around sixty, and now it is around 80. Could it be his heart is weakening?
Hello. In atrial fibrillation, the heart beats can vary in frequency and height (amplitude). What is more important in these patients is that the rate needs to be controlled and not above 100 beats per minute. Also, one must make sure that no clot forms in the heart due to the abnormal heartbeats. I have seen the monitor pictures (attachment removed to protect patient identity) and they do not look concerning.  One must make sure that there is no clot forming in the heart which can give rise to the stuttering nature of the stroke as in his case. I would recommend a transesophageal echocardiogram to detect the presence of thrombus in the left atrium. If the thrombus is present, he requires anticoagulation with heparin. If the thrombus is absent, oral anticoagulants are enough. For more information consult a neuro surgeon online -->