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Hi,

I'm a 32 year old male.  I had an episode of atrial fibrillation 3.5 years ago where I went to the Emergency room and it was captured on ECG.  Prior I had worn holter monitors which documented a few PACs but nothing else.  I also had a treadmill test and an echocardiogram as well as a number of resting ECGs before and after the incident of afib which came back normal.  I saw an EP who just prescribed me a baby aspirin as my blood pressure was a little high when I saw him.  I have since had an ambulatory blood pressure monitor which came back normal.  I have not had a sustained episode of afib since but I do get a racing, irregular heart beat which lasts for no more than 5-10 seconds.  This happens maybe once every 6 months.  If it happens when I'm lying down it stops when I sit up.  

So my first question is does this sound consistent with an afib episode or is it more likely to be a different type of rhythm?  I do get skipped beats often especially when I bend over.  

Secondly, I'm extremely worried about my stroke risk.  I definitely suffer from health anxiety and I've been reading all sorts of studies that have got me really worked up.  Even though my CHA2DS2-VASc score would be 0 this study says that my stroke risk would still be 0.23 per 100 person years.  

http://publications.chestnet.org/data/Journals/CHEST/23326/110862.pdf?resultClic  

What concerns me is that according to this the the risk for white males is just 41.7 out of 100,000.

http://www.strokeassociation.org/STROKEORG/AboutStroke/Impact-of-Stroke-Stroke-s  

These odds indicate that I have a 2.3 out of a 1000 chance of having a stroke in the next year versus the general population having a 0.417 out of 1000 chance of having a stroke which is still a 5 and a half times higher chance of stroke than the general population.  Am I looking at these stats incorrectly?

Meanwhile, this study shows that patients with lone atrial fibrillation have equal mortality to the general population and similar stroke risk until they are at least in their 60's.  

http://www.ncbi.nlm.nih.gov/pubmed/17548732


So all of this data is really confusing me and making me extremely stressed and anxious.  

Thank you for your help.

Answer
Hi Dustin,
A CHA2DS2-VASc score of 0.23 is very low: the use/risk of an anti-coagulant needs to be weighed against the risk of stroke. The score says no. Whether you are an exception I don't know and cannot judge from here.
Hope this helps,
Dr T
http://www.cardiachealth.org/

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