What is the risk?

AF leads to stagnation of blood in heart and formation of clots which if embolize to arteries (tubes from heart carrying oxygenated blood) to brain can lead to stroke. Life after stroke can be devastating. Thus, prevention and correction of AF is most important single step to prevent stroke.

Every patient with atrial fibrillation should have a thromboembolic risk assessment. The overall risk of stroke is 5%/year (3-5 fold higher than those without AF). Very high-risk populations include rheumatic heart disease (up to 20%/year), prosthetic heart valves, and previous/recent stroke/TIA (12%/year). Traditional intermediate risk factors for stoke include age > 65, hypertension, heart failure, diabetes, coronary artery disease, and LV impairment on echocardiography. Younger patients with no structural heart disease (lone AF) are at very low risk. Warfarin reduces the risk by 2/3 and aspirin by 1/5.

AF is also associated with increased incidence of sudden death, heart failure and vascular dementia

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