If you have atrial fibrillation (AFib), your heart beats irregularly. As a result, your heart has a harder time pumping blood out and to the body.
When this happens, blood can pool in the heart and form clots. If a blood clot travels through the bloodstream, it can block a blood vessel in the brain and cause a stroke.
On average, people with AFib are 5 times more likely to suffer a stroke than those with a normal heartbeat. Strokes related to AFib are often more severe than strokes from other causes.
What does that mean for you or a loved one who has AFib?
When a stroke happens, it tends to be debilitating, often leaving someone fully dependent on others for daily tasks such as dressing, and getting in and out of bed. It might also steal your ability to talk or think clearly.
Stroke is a leading cause of death and disability.
The good news is that blood thinners, also called anticoagulants, can be used to lower the risk of stroke. It is estimated that 3 out of 4 AFib-related strokes can be prevented. This is why a doctor may prescribe an anticoagulant for people with AFib.
“In general, most bleeding [related to anticoagulants] can be managed successfully and do not result in irreversible damage (with the exception of intracranial bleeding, which is very rare). In contrast, strokes are more likely to cause disability and can be life-altering, especially for young people,” said Mikhael F. El-Chami, MD, a heart specialist at Emory Healthcare.
While the likelihood of a major bleed from taking an anticoagulant is 2%-3% on average, the risk of stroke is higher. On average, the risk of having a stroke is 5% each year among people with AFib.
The trick is that two people with AFib may have very different risks of stroke and bleeding. That’s why reviewing your risks of both stroke and bleeding and making an informed decision with input from your doctor is important.
The good news is there are many options nowadays for blood thinners.
“We have more options than ever,” said Dr. El-Chami. “Some of the newer anticoagulants have lower risks of bleeding compared with warfarin, and all of the newer drugs have a lower risk of bleeding in the brain (intracranial hemorrhage).”
It’s important to talk with your doctor about your risk of stroke and bleeding, and your risk for either or both may change over time.
Risk Factor |
Points |
Congestive Heart Failure |
1 |
High Blood Pressure |
1 |
A2: > 75 years old |
2 |
Diabetes (type 2) |
1 |
Stroke or Mini-Stroke |
2 |
Vascular Disease (heart attack, peripheral artery disease) |
1 |
Age: 65-74 years old |
1 |
Sc: Female Sex |
1 |