What is atrial fibrilation and how is it linked to strokes?

A study published in New England Journal of Medicine revealed that atrial fibrillation may increase the risk of having a stroke. The study was conducted on  2,580 participants, 10 percent of those having  subclinical atrial fibrillation. After three months it was discovered that the subjects belonging to the former group   were 2.5 times more prone to suffer from strokes and other such diseases that require emergency treatment. 

But what is atrial fibrillation?

Many of us probably felt sometimes heart palpitations, but overlooked it as nothing important. Although it doesn't causes any real symptoms, such things as heart palpitations, or a pain in the chest can be associated with atrial fibrillation.

Atrial fibrillation or AF happens when the upper two chambers of the heart also known as the atria, beat irregularly fast  . This can lead to situations where the heart is unable to provide normal blood flow and oxygen delivery to the rest of the body.  That's why AF patients may complain about having problems with breathing ,especially when exercising or doing any other kind of physical effort.
AF can lead to strokes, depending on the age and condition of the person ,since it may favor the apparition of blood clots.

Atrial fibrillation may be caused by a number of different things such as :

• High blood pressure
• Different heart diseases such as  congenital heart disease, mitral stenosis, coronary artery disease.
• A previous heart surgery
• Diseases of the lung
• Excessive consumption of alcohol
• Intoxication with  carbon monoxide

If you think you may have atrial fibrillation you may easily check this with an  electrocardiogram or EKG test. It's highly recommended to take this test if you experienced the following symptoms:

•          heart palpitations
•          chest pains
•          fainting
•          dizziness
•          breathing problems
•          intolerance to exercise.

There are a number of different treatments for AF, among them listing the intake of an anticoagulant, to prevent the apparition of blood clots.

Safety warnings about Pradaxa

The number of  injuries reports from patients who have taken Pradaxa went so high that in 2011 on  Dec. 7, the FDA had to announce a safety alert regarding the risk of internal bleeding in patients who were administered Pradaxa. We already covered in the last how and why in such cases, a minor injury can lead to serious complications for individuals taking  Dabigatran.

We also established why the risk is even higher with the elderly, so we are going to try and expand this subject and see in what other conditions is best and safe to avoid the use of Pradaxa.

We are going to start by discussing about the safety information posted on www.pradaxa.com.

As expected, patients are not recommended to take pradaxa if they have abnormal bleeding or an allergic reaction to it. Furthermore, we are warned that the risk of bleeding is higher for people with the age of 75 or above or for people with kidney problems.

As any other drug, Pradaxa is eliminated through the kidneys, so if they are unable to excrete it, that may lead to high levels of the drug stuck in the system.
Pradaxa is not also recommended for those with  stomach ulcer or intestine bleeding, nor is it advised to take Pradaxa along with other drugs and products known for their blood thinning properties such as aspirin products or non-steroidal anti-inflammatory drugs  . To sum it all up, try to avoid Pradaxa if you :

•  are 75 or older
• have kidney problems and especially if you take drugs for that.
• have stomach ulcer or intestine bleeding
• are currently taking other blood thinners or products known to have such attributes.

A consultation with the doctor may be the best solution to assure everything is in order before taking Pradaxa. Also don't forget to tell him about any treatments , pills or vitamins you are taking and if you plan to have a surgery soon, even if it's a simple dental procedure .
A simple detail like that may make the difference later.

And don't forget if you failed to get good advice from your doctor, you may seek advice with a Pradaxa attorney and get compensation.

Pradaxa may lead to uncontrollable bleeding

       Earlier this year, a study conducted by researchers Ken Uchino from Cleveland Clinic and MD Adrian V. Hernandez, involving seven clinics and 30,514 patients revealed that patients who are taking the anticoagulant drug Pradaxa may present a 33% higher risk of heart attack or heart disease than patients who were taking other drugs such as warfarin.

Researchers Ken Uchino and Adrian Hernandez concluded that : "The risk of [heart attack] or acute coronary syndrome is increased with [Pradaxa] compared with various control treatments, which include adjusted-dose warfarin, [Lovenox], or placebo.

Even though Pradaxa was found to have some great benefits in preventing strokes,does that outweigh its risks?



It may be hard to tell,but what is certain is that this is not the first warning signal about Pradaxa.

Only one year after it was launched, FDA issued a safety alert regarding the risks of internal bleeding in patients using Pradaxa. This may have come as a result of over 117 deaths over the spawn of only one year and numerous other reports of injuries after using Pradaxa.


The problem with this drug is that unlike other anticoagulants, it does not have an antidote. That means that every time someone is experiencing some severe problems after using Pradaxa and finds himself in need of emergency treatment , the only option is to undergo dialysis, that is to mechanically remove the substance from the patient's blood stream which may take several hours. Hours that a patient may not have .


Just a couple a months ago, an 83 year old man died after suffering a hit on the head from a minor fall. It was not the impact that killed him , in fact what proved to be fatal for him was the uncontrollable internal bleeding.


Usually when they get patients with severe bleeding, doctors will try to stop that by using an intravenous fluids or a protein called recombinant factor VIIa. Unfortunately these procedures are useless for patients who have been using Pradaxa . Not even a dose of Vitamin K which worked perfectly with warfarin can be of help. By the time doctors can remove Pradaxa from the system through dialysis , the patient may have already lost too much blood .


It is a grim view for the elderly folk knowing that a simple fall or injury may prove fatal for them .

As the name implies, an anticoagulant is an agent , a substance that prevents blood
coagulation or clotting. The process of coagulation could be seen as a defense mechanism needed to prevent blood loss from a damaged blood vessel. It does that by covering the blood vessel with a clot in order to stop bleeding and start repairing the vessel. Coagulation begins almost instantly after an injury and it is a process absolutely vital for survival.
That is why disorders in coagulation can lead to very serious affections varying from excessive bleeding to Thrombosis (obstructive clots, restricting the normal circulation.)
Thrombosis could be generated by a series of abnormalities such as:
-blood composition
- quality of the vessel wall
- turbulence in the blood flow.
Thrombosis is very dangerous as it restricts the normal blood flow, thus depriving cells of oxygen. This is where anticoagulants step in . The other side of the coin is that while they reduce the thromboembolic occurrence they also increase the risk of bleeding. Needless to say, the use of such drugs require careful monitoring.



One of the most popular anticoagulant marketed in the U.S. , Europe , Australia and Japan is dabigatran etexilate, known by the majority by its more marketable name, Pradaxa.


Pradaxa was granted marketing authorisation by the European Medicines Agency on March 18, 2008 for prevention of such affection as thromboembolic disease , hip and knee replacement surgery and non-valvular atrial fibrillation.
In the US, FDA gave its approval on Pradaxa on October 19, 2010 as a treatment in prevention of stroke and non-valvular atrial fibrilation, after the advisory committee recomended Pradaxa for approval on September 20, 2010.


The name behind Pradaxa is the pharmaceutical company Boehringer Ingelheim and their product quickly gained popularity as its presented itself as a more friendly alternative to warfarin , another anticoagulant of the time. Although caution was advised, Pradaxa did not require such a strict level of monitoring like other products on the market. 


Even though it's referred  by many as a "blood thinner", it is important to know Pradaxa does not make the blood "thinner". What it's actually does is inhibits an enzyme called thrombin that has an importan part in blood coagulation.

As I specified somewhere above, that process can be a double-edged sword.
But did Pradaxa manage to do its job?