Heart Education Awareness Resource and Training through eLearning (HEARTe)

Consequences of AF – stroke risk

AF is associated with a five-fold increase risk of stroke and a three-fold incidence of congestive heart failure, and higher mortality. Over 6 million Europeans suffer from this arrhythmia, and its prevalence is estimated to at least double in the next 50 years as the population ages. Ischaemic strokes (or embolic stroke as above) are often fatal when associated with AF. Those patients who do survive are left more disabled and are also more likely to suffer a recurrence than patients with other types of stroke. In consequence, the risk of death from AF-related stroke is doubled. (ESC 2010, 2012).

Clot formation

In AF, the atria do not pump efficiently which means that not all of the blood is pumped from the atria into the ventricles. The blood that remains in the atria pools and as a result of this stasis a clot or thrombus can form.

If the clot breaks off and moves, it can travel to the brain. The strokes caused by AF can be more disabling as the further an embolus travels the larger it can become and the vessels in the brain are narrow and so are easily occluded.

How can AF cause an ischaemic stroke?

During atrial fibrillation, clots form in the heart and can then be carried through the circulation towards the brain causing ischaemic stroke.

Blood clots can form in the left atrial appendage. These clots can travel in the blood to the brain, where they may block the blood flow, causing a stroke.

Pulse point

You may wish to review module 3 in HEARTe and in particular the pathophysiology relating to cardiovascular disease. Access STARS core competencies to learn more about stroke.
Access the advancing modules within STARs and in particular the Reducing the risk of stroke module. You may also find the following video from CHSS useful as it highlights the need to recognise the symptoms of stroke as a medical emergency. FAST video CHSS

Page last reviewed: 29 Jul 2020