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AFib and Stroke: Are They Related?

People with Atrial Fibrillation (AFib) are 5x more likely to have a stroke than the general population. If AFib affects the heart and stroke affects the brain, how can they be related? Keep reading to learn more about AFib and stroke and the connection between them. 


What is AFib?

AFib is a type of irregular heartbeat or arrhythmia. This means the heart is beating in an irregular pattern. It’s the most common irregular heartbeat globally, affecting over 37 million people.


AFib Symptoms

Some people with AFib have symptoms and others don’t. For most people, symptoms become more obvious with physical activity. Sometimes, it’s possible to feel your heart racing even at rest. Your irregular heartbeat triggers these symptoms.

Common symptoms of AFib include:

  • Irregular heart rhythm

  • Fast heart rate

  • Palpitations in chest

  • Shortness of breath

  • Chest pain

These symptoms may come and go. They can be present with activity or at rest.


What is a Stroke?

A stroke happens when a part of the brain isn’t getting enough oxygen. A clot could be blocking a blood vessel that delivers oxygen, or there could be bleeding in the brain. Without enough oxygen, the brain is quickly damaged. A stroke is an emergency. Anyone experiencing stroke symptoms should call 911 right away.


Stroke Symptoms

The brain needs oxygen to work like it should. Stroke symptoms happen when the brain isn’t getting enough oxygen. Symptoms may be temporary or permanent. They can range from mild to severe, or even death. 

The acronym to remember stroke symptoms is F.A.S.T.

  • Face

  • Arms

  • Speech

  • Time to call 911

Look for drooping on one side of the face, less strength in one arm, or problems speaking. These could be signs of a stroke and you should call 911.


How Does AFib Cause Clots and Strokes?

In AFib, the heart beats in a disorganized way. Blood should flow in one direction through the heart, like a one-way street. Instead, with AFib it swirls around the top chambers of the heart, and not all the blood empties. This allows clots to form.



When a clot forms, it can travel to other areas of the body, such as the lungs or brain. When the clot reaches a small blood vessel it can block blood and oxygen from passing. If the clot travels to the brain it causes a stroke.


How Can I Reduce the Risk of Stroke if I Have A-Fib?

If you have AFib, there are some steps you can take to lower your chances of having a stroke. Your doctor may prescribe several medications and recommend lifestyle changes. In rare cases, your doctor may recommend a procedure. 


Blood Thinners

When you have AFib, the chances of developing a blood clot are higher. To help protect against blood clots, your doctor may prescribe a blood thinner. By preventing clots, you can continue to get good blood and oxygen to your brain.


Side effects

Blood thinners increase your chance of bleeding if you get a cut. They also increase the risk of bleeding internally if you injure yourself. Be careful to prevent falls or injuries to your head. If you do get injured, seek medical attention. 



Heart Rhythm and Rate Control

Blood clots form in AFib because of an irregular heartbeat. It doesn’t allow blood to move through the heart the way it should. Your doctor may prescribe medication to control the heart rhythm and speed.


Lifestyle changes

Up to 82-90% of all strokes are the result of risk factors you can control. These risk factors are related to lifestyle. By living a healthy lifestyle, you lessen your chances of having a stroke, even if you do have AFib.

Lifestyle factors:

  • Manage high blood pressure

  • Manage weight

  • Stay physically active

  • Eat a healthy diet

  • Quit smoking

Talk to your doctor to determine which lifestyle changes you should make.


Left atrial appendage closure

In very rare cases, your doctor may recommend a procedure called left atrial appendage closure. This procedure is done if someone cannot take a blood thinner for serious reasons. This procedure keeps blood clots from leaving your heart to prevent strokes.


Should I take blood thinners to prevent stroke even if I don’t have AFib?

Blood thinners are not effective in preventing stroke for people who do not have AFib. There also is a higher risk of bleeding while taking blood thinners. It is not worth the risk of having a serious bleed from the medication for someone who does not have AFib. 


Is AFib the only risk factor for stroke? 

About 25-30% of strokes are caused by Afib. AFib is not the only risk factor for stroke. Many risk factors are lifestyle factors. Eat a healthy diet, stay active, and manage your weight to reduce the risk of stroke.

Other risk factors include:

  • Advanced age

  • Stress

  • Family history of stroke

Work with your doctor to manage your AFib and other risk factors.


Conclusion

When you have AFib, this increases your chance of having a stroke. With AFib the heart pumps blood in a disorganized way which can cause clots to form. These clots can travel to the brain and cause a stroke. Work with your doctor to reduce your risk factors. These include taking your medications and a healthy lifestyle.


References


American Heart Association. What is atrial fibrillation?. www.heart.org. (2023, March 29). https://www.heart.org/en/health-topics/atrial-fibrillation/what-is-atrial-fibrillation-afib-or-af 


American Stroke Association. Stroke symptoms and warning signs. www.stroke.org. (n.d.). https://www.stroke.org/en/about-stroke/stroke-symptoms 


Bertaglia, E., Blank, B., Blomström-Lundqvist, C., Brandes, A., Cabanelas, N., Dan, G.-A., Dichtl, W., Goette, A., de Groot, J. R., Lubinski, A., Marijon, E., Merkely, B., Mont, L., Piorkowski, C., Sarkozy, A., Sulke, N., Vardas, P., Velchev, V., Wichterle, D., & Kirchhof, P. (2019). Atrial high-rate episodes: Prevalence, stroke risk, implications for management, and clinical gaps in evidence. EP Europace, 21(10), 1459–1467. https://doi.org/10.1093/europace/euz172 


Caturano A, Galiero R, Pafundi PC. Atrial Fibrillation and Stroke. A Review on the Use of Vitamin K Antagonists and Novel Oral Anticoagulants. Medicina. 2019; 55(10):617. https://doi.org/10.3390/medicina55100617


Centers for Disease Control and Prevention. (2022, October 14). Atrial fibrillation. Centers for Disease Control and Prevention. https://www.cdc.gov/heartdisease/atrial_fibrillation.htm 


Lip, G. Y., Proietti, M., Potpara, T., Mansour, M., Savelieva, I., Tse, H. F., Goette, A., Camm, A. J., Blomstrom-Lundqvist, C., Gupta, D., & Boriani, G. (2023). Atrial fibrillation and stroke prevention: 25 Years of research at EP Europace Journal. Europace, 25(9). https://doi.org/10.1093/europace/euad226 


Lippi, G., Sanchis-Gomar, F., & Cervellin, G. (2021). Global epidemiology of atrial fibrillation: An increasing epidemic and public health challenge. International journal of stroke : official journal of the International Stroke Society, 16(2), 217–221. https://doi.org/10.1177/1747493019897870


U.S. Department of Health and Human Services. (n.d.-a). Causes and risk factors. National Heart Lung and Blood Institute. https://www.nhlbi.nih.gov/health/stroke/causes 


U.S. Department of Health and Human Services. (n.d.-b). What is a stroke?. National Heart Lung and Blood Institute. https://www.nhlbi.nih.gov/health/stroke 

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