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What are the risks of AF?

AF-related stroke

The main risk associated with AF is stroke. This occurs because when a person is in AF, the atria (the top chambers of the heart) are fibrillating and not beating in a co-ordinated way. The lack of sufficient contraction means that the blood in parts of the atria becomes stagnant and can form clots. These clots can break off and travel anywhere in the body, but most worryingly, they can travel to the brain and cause a stroke. AF-related strokes are often more damaging than other kinds of stroke. A doctor will assess your personal risk of stroke when you have been diagnosed. The chart below can help you to also do this:

Question Points Your Score
Do you have congested heart disease?     1  
Do you have hypertension (high blood pressure)?     1  
Are you over 75?     2  
Do you have Diabetes?     1  
Have you suffered a stroke (even a mild stroke)?     2  
Do you have vascular heart disease?     1  
Are you aged between 65 and 74 years?     1  
Are you female?     1  
                                                                                    Total score  

Your annual risk of stroke rises from under 2% a year with no risk factors to over 10% a year for five or six. Experts who use this scoring scheme (the CHA2DS2-VASc score) may suggest that the tipping point for benefitting from taking anticoagulants over their risks is at a score of 2 or above. However, there are situations where, even with a score of less than 2, anticoagulation may be recommended.

Reducing AF-related stroke risk


Heart Failure

Having an uncontrolled heart rate for long periods of time (weeks or months) can damage the heart and you should check with your doctor that your heart rate is controlled adequately. In extreme cases, often when the rate is very fast or when it happens in a damaged heart, AF can cause heart failure, which means that the heart becomes weak, as a result of the rapid rhythm. As the heart weakens, blood flows back into the lungs and affects the normal breathing pattern.

AF is also associated with a slightly increased risk of death although this is a very small risk and generally AF is not considered a life threatening disease in its own right. Why AF is associated with increased risk of death is not understood.