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Stroke and Atrial Fibrillation

Afib Can Cause A Stroke
Take Your Rat Poison.

Stroke and Atrial Fibrillation go hand in hand and many afib patients first learn they have afib when they are treated for a stroke!

Atrial fibrillation causes the upper chambers of the heart to quiver in an uncoordinated fashion with no effective pumping of blood.

As a result, blood becomes stagnant and clots can form within the heart, which then may break loose and be carried downstream to the brain where they block blood flow and cause a stroke.

Atrial fibrillation is associated with a risk of stroke of 5 percent per year, and is responsible for 70 to 100 thousand strokes per year in the US.

Blood thinner (warfarin) reduces the risk of stroke by 60-70 percent, to 1 to 2 percent per year, but does not completely eliminate the risk of stroke, and is associated with a risk of bleeding.

Only 40 percent of patients with atrial fibrillation in the US are treated with warfarin, mostly because of concerns of bleeding. It is estimated that more than 35 percent of patients with atrial fibrillation will have a stroke during their lifetime. 

The incidence of stroke in people with atrial fibrillation (Afib) can range from 5 to 17-fold higher than that of people without afib.   
Currently, strokes are best prevented by the careful use of Coumadin® or warfarin.  The warfarin dose must be carefully adjusted to maintain the proper amount of anticoagulation (commonly called blood thinning) 
Atrial Fibrillation Stroke 'Tragedy' 
Far too many people with atrial fibrillation suffer preventable strokes. 
The "tragedy" is that Coumadin, an inexpensive blood thinner, could prevent about half of these strokes, yet few high-risk patients get proper treatment. 
On one hand, we have an extremely effective and cheap medication for stroke prevention -- Coumadin -- yet on the other hand it remains under-used in people who would benefit most from it the most.
I Want My Rat Poison! 
Warfarin was originally invented to kill rodents.  Later was it discovered that tiny doses of the drug act as a powerful blood thinner.  But the therapeutic window -- the difference between no effect, a helpful effect, and a harmful effect -- is relatively small. 
It is sometimes hard to maintain patients at the correct level long term.  It is a real nuisance." 
It is a nuisance for the patients and the doctors.  But you know what a bigger nuisance is 
If you have Afib - Shut up and take your Rat Poison!! 

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