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Does Atrial Fibrillation Increase Stroke Risk?

It can happen at any time: Suddenly your heart starts to race or you feel a flutter in your chest. Worried, you wonder what’s wrong.

It might be atrial fibrillation, also known as AFib, a common heart arrhythmia that affects about 3 million Americans. AFib disrupts the blood flow through your heart and can increase your risk of stroke.

Normally, blood flows from the upper chambers of the heart to the lower chambers and then out in a very fluid motion. When someone experiences atrial fibrillation, the upper chamber quivers instead of pumping blood one heartbeat at a time.

Symptoms of AFib include:

  • Rapid and irregular heartbeat, which may be undetectable to the patient
  • General fatigue or weakness
  • Shortness of breath
  • Dizziness or feeling faint

Decrease Your Stroke Risk

When your heart is in AFib, whirlpools of blood develop in the upper chamber. These pools get caught up in the nooks and crannies of the upper chamber, and clots can form. The clots then can move into your circulatory system and sometimes wedge themselves into a blood vessel in the brain, causing a stroke.

Stroke is the fifth-leading cause of death in the United States, and studies show that Americans with atrial fibrillation are five times more likely to suffer a stroke. The B.E.F.A.S.T. slogan was developed to help remind consumers about the signs of stroke.

With AFib, the key to reducing your chances of having a stroke is thinning the blood.

Doctors take several factors into consideration to determine your risk of a stroke. These include age and gender, and whether you have conditions such as prior stroke, hypertension, diabetes, congestive heart failure or coronary artery disease.

For those with the lowest risk, generally low-dose aspirin is adequate for preventing strokes. Patients with a higher risk of stroke probably will be prescribed an oral anti-coagulation drug.

Medications such as warfarin, a blood-thinning drug, have been around for many years. They help prevent clots from forming and decrease the risk of a stroke in up to 65 percent of patients. Other drugs — Eliquis, Pradaxa and Xarelto, to name a few — entered the market more recently and are considered safer and equally effective in thinning your blood.

Those at highest risk of stroke — and who are unable to take an oral anti-coagulation drug long term — might have a device implanted called a Watchman, which is a filter that is placed into a small pouch in the left upper chamber of the heart to prevent clots from getting out.

Lifestyle Changes

To minimize the risk of AFib, the American Heart Association suggests adopting a heart-healthy lifestyle, including:

  • Exercising
  • Eating foods low in salt, cholesterol, and saturated and trans fats
  • Limiting alcohol and caffeine
  • Managing high blood pressure
  • Managing diabetes
  • Giving up smoking
  • Maintaining a healthy weight

Understanding AFib

AFib is a progressive disease, so the sooner it is diagnosed and treatment begins, the better. If not treated, atrial fibrillation can lead to an enlarged heart, scarring and weakening of the upper chamber, and ultimately more serious problems. Once AFib progresses, it becomes much harder to control.

In the past 20 years, research about atrial fibrillation has ramped up, leading to new therapies.

If your AFib episodes come and go, doctors will try to keep it from becoming persistent. If you are having atrial fibrillation lasting several minutes, they will try to keep it from lasting hours or days.

More recently, ablation therapy has become a common treatment option. Ablation therapy is a minimally invasive procedure that involves using energy to zap abnormal scar tissue and help restore your heart’s normal rhythm.

Some patients might be skeptical about having an ablation procedure done, but this treatment has proved effective for those suffering from AFib.

AFib and COVID-19

People who have had COVID-19 and recovered — particularly those with more serious cases — have reported lingering heart-related symptoms. Some who previously had AFib report that they are experiencing more aggressive symptoms. Others have developed fluid in their lungs or congestive heart failure.

It’s unclear what the long-term implications might be. Call your doctor if you’ve had COVID-19 and notice new or worsening AFib symptoms.


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