Stroke caused by afib, CHADS VASc, Left atrial appendage


Afib, Arrhythmia, Cardiology, Medicine

Strokes caused by afib

To understand how are strokes caused by afib, we need to look at a part of the heart called the left atrial appendage. This part of the heart is kind of like the heart’s tail.  When afib starts, the atria shakes like jelly. This type of movement does a bad job at pushing blood out of the top part of the heart and into the bottom. Because of this, some of the blood pools inside the heart’s little tail, where it settles and can form blood clots.

blood clot in heart are responsible for strokes caused by afib
The left atrial appendage can squeeze the clots out into the body. The most common place a blood clot goes after it leaves the heart is the brain.
the left atrial appendage cause strokes in afib

In afib, some of these formed clots inside the left atrial appendage can detach. If the heart breaks out of afib and starts squeezing normally again, the tail appendage can squeeze the clots out. The clots can then be launched into the body. The most common place a blood clot goes after it leaves the heart is the brain. If a clot lands in your brain, it can obstruct the blood flow and cause a stroke. A stroke can have a huge impact on a person’s life, even taking away their ability to talk and move independently. 

Calculating Your Stroke Risk

If you have afib, it is important to find out your stroke risk so you can decide if you need to protect yourself from one. Fortunately there is a tool that can help you and your doctor quickly determine your risk. This tool is called the CHADS VASc score. This score looks at all the factors that increase stroke risk in people with afib.

The CHADS VASc score looks at all the factors that increase your stroke risk if you have afib.
If your score adds up to 0 or 1, then your stroke risk is low.
For any score over 2, protection with a blood thinner or what is called an occlusion device is recommended.

Calculate your CHADS VASc Score here by adding all the conditions that apply to you:

Stroke Prevention in Atrial Fibrillation

Warfarin can prevent strokes in patients with afib.

Until recently, Coumadin, also known as Warfarin, was the only choice of blood thinner available for patients with afib. Coumadin can protect from a stroke but it is a very difficult drug to take as it requires frequent testing. Fortunately, there are now four new oral blood thinners that do not need regular blood draws for monitoring and have minor interactions with food and other medications. 

If a patient is bleeding or is at high risk of bleeding because of frequent falls, job activities or sports, or has had head trauma, an occluding device for the left atrial appendage is recommended. An occluding device may also be used if the patient has a history of not taking their prescribed medications.

Doctors in the US offer two occlusion devices that can protect you permanently from a stroke:

The Watchman Device: Plugs the atrial appendage.
The Watchman® Device:

A plug is placed inside the left atrial appendage so clots cannot settle inside of it.

The Lariat Device ties off the left atrial appendage
The Lariat® Device:

Ties off the left atrial appendage altogether so it can no longer cause the problem.

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Last Modified: Jan 22, 2018 @ 6:48 pm
About the Author

Jorge Romero M.D. F.A.C.C. F.H.R.S.


Jorge Romero, MD, is an Attending Physician and Assistant Professor of Medicine in the Arrhythmia Service of the Cardiology Division at the MontefioreEinstein Center for Vascular Care. He specializes in the treatment of complex arrhythmias, particularly in catheter ablation of ventricular tachycardia and atrial fibrillation using cutting-edge technology. Dr. Romero is a member of the American Heart Association (AHA), and a fellow of the Heart Rhythm Society (FHRS) and the American College of Cardiology (FACC).


Jose Taveras M.D. F.A.C.C.


Dr. Taveras is a non-invasive cardiologist in the Montefiore-Einstein Center for Heart and Vascular Care in Bronx, New York. He trained in both internal medicine and pediatrics and is currently an assistant professor of medicine at Albert Einstein College of Medicine. Dr. Taveras is a fellow of the American College of Cardiology. He is the co-creator of Doctablet.

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