What are the risks of Atrial Fibrillation?

Stroke

The main risk associated with AF is stroke. This occurs because the atria are fibrillating and not beating in a co-ordinated way. The lack of sufficient contraction means that the blood in the atria becomes stagnant and can form clots. These clots can break off and travel anywhere in the body, but most worryingly, they can travel to the brain and cause a stroke.

Many healthcare professionals now use an assessment tool which has international recognition and approval: CHADS2 or CHA2DS2VASc.

CHADS2

Congestive heart disease 1 point
Hypertension                        1 point
Age (75 years +)                  1 point
Diabetes                                1 point
Stroke or previous TIA         2 points

Score

If you score 0 points and are aged under 65 years, you are at no risk of AF-related stroke. Therefore, there is no necessity to be on anticoagulant or antiplatelet treatment.

If you score 0 points and are aged over 65 years, you are at low risk of AF-related stroke. Therefore, there is no necessity to be on anticoagulant or antiplatelet treatment.

If you score 1 point, you are moderate risk of AF-related stroke. Therefore, you might be considered for treatment, depending on other factors such as your age.

If you score 2 points, your are at high risk of AF-related stroke. Therefore, you should be considered for anticoagulant treatment.

CHA2DS2VASc (developed since 2010)

Congestive heart disease 1 point
Hypertension                        1 point
Age (75 years +)                  2 points
Diabetes                                1 point
Stroke or previous TIA         2 points
Vascular heart disease      1 point
Age (65-74 years)                1 point
Sex category (female)         1 point

Score

If you score 0 points, you are low risk. Therefore anticoagulant or antiplatelet treatment is not necessary.

If you score 1 point, you are at moderate risk. Therefore, you should be considered for treatment.

If you score 2 points or more, you are at high risk. Therefore, anticoagulant treatment is recommended.

Professor Ben Freedman, Prof. of Cardiology, Concord Hospital and spokesperson for AF Association Australia, raised awareness AF and highlights a diagnostic device that can screen for AF during World Heart Rhythm Week 2012:

Heart Failure

Having an uncontrolled heart rate for long periods of time (weeks or months) can damage the heart and you should check with your doctor that your heart rate is controlled adequately. In extreme cases, often when the rate is very fast or when it happens in a damaged heart, AF can cause heart failure, which means that the heart becomes weak, as a result of the rapid rhythm. As the heart weakens, blood flows back into the lungs and affects the normal breathing pattern.

AF is also associated with a slightly increased risk of death although this is a very small risk and generally AF is not considered a life threatening disease in its own right. Why AF is associated with increased risk of death is not understood.