Written by Atrial Fibrillation & Stroke Prevention
What is Atrial Fibrillation?
Atrial fibrillation (AF) is an irregular heart rhythm (arrhythmia) that causes the upper chambers of the heart (atria) to beat chaotically. This can lead to poor blood flow and increases the risk of blood clots forming.
Why AF Increases Stroke Risk
Because the atria do not contract effectively, blood may pool and clot. If a clot travels to the brain, it can cause a stroke. People with AF have about a fivefold higher risk of stroke compared with those without AF.
Diagnosis in the UK
AF is usually detected by:
- Pulse check: Your GP may notice an irregular heartbeat.
- Electrocardiogram (ECG): The gold-standard test.
- Ambulatory monitoring: 24-hour Holter monitoring if AF is intermittent.
Stroke Prevention Treatments
The main approach is to reduce the risk of blood clots forming:
- Anticoagulants: Direct oral anticoagulants (DOACs) such as apixaban, rivaroxaban, edoxaban, or dabigatran are now first-line in the NHS. Warfarin is used less often but may be appropriate in some cases.
- Aspirin: Not recommended for stroke prevention in AF.
- Left atrial appendage occlusion: Considered if anticoagulation is unsuitable.
Treatment choice is based on a risk assessment tool such as CHA2DS2-VASc (for stroke risk) and HAS-BLED (for bleeding risk).
Lifestyle & Self-Management
- Attend regular GP or cardiology check-ups.
- Take medication exactly as prescribed.
- Limit alcohol and caffeine, as they can trigger AF episodes.
- Maintain a healthy weight and stay physically active with safe, moderate exercise.
- Manage blood pressure, diabetes, and cholesterol.
FAQs
Can AF go away on its own?
Sometimes AF episodes stop spontaneously, but many people need long-term management.
Do all people with AF need anticoagulants?
Not always—treatment depends on individual stroke risk assessment. Your GP or cardiologist will guide you.
References
- NICE Guideline [NG196]: Atrial fibrillation: diagnosis and management
- British Heart Foundation: AF and stroke prevention
- Stroke Association UK: Atrial fibrillation and stroke