Atrial fibrillation (AFIB) is one of the most common causes of stroke in the United States. AFIB increases the stroke risk fivefold.
The left atrial appendage is the most common area where clots form in atrial fibrillation. These clots are then expelled from the left side of the heart to the brain, block blood supply to the brain and therefore cause a stroke.
Remember this for stroke – FAST
- Facial drooping
- Arm weakness
- Speech difficulties
- Time is of the essence if any of the above are present
90% of the strokes related to atrial fibrillation can be prevented by using anticoagulants like warfarin, Pradaxa, Eliquis and Xarelto in patient with CHA2DS2-VaSC score of 2 or greater.
For patients at high risk of stroke who cannot tolerate anticoagulants, consideration can be given to the Watchman device or Atriclip.
We are still trying to fully understand the mechanisms of stroke with atrial fibrillation. While majority of the clots form in the left atrial appendage, clots may form in other areas of the heart as well and they can also form spontaneously in the brain.
Inflammation may play a role in AFIB related stroke as well.