AFib & Stroke Prevention

Roughly 10.5 million Americans — about 1 in 20 U.S. adults — live with atrial fibrillation (AFib), a heart condition marked by an irregular, rapid heart rhythm. AFib occurs when the upper chambers of the heart (atria) beat irregularly.

While AFib is highly treatable, untreated AFib can lead to serious complications, like stroke. In fact, adults with untreated AFib are five times more likely than those without the condition to suffer a stroke.

To reduce atrial fibrillation stroke risk, you should work with a provider to screen for and treat AFib. Thankfully, the condition is almost always treatable.

Key Takeaways: Stroke Risk And AFib

• AFib is a major cause of stroke. The condition, which causes an irregular heart rhythm, can lead to the formation of blood clots that can travel to the brain.
• Treating AFib reduces your stroke risk. With proper treatment, including lifestyle changes, medications for atrial fibrillation, and, when necessary, medical procedures, the risk of stroke can be significantly reduced.
• Blood thinners are a primary treatment for AFib. Anticoagulants (blood thinners) are used to prevent dangerous blood clots. For those who can't take these heart medicines, a device called a Left Atrial Appendage Occluder (LAAO) may be an option.

What Is AFib?

Atrial fibrillation (AFib) is a heart rhythm disorder that causes an irregular, fast heartbeat. The condition affects roughly 1 in 20 U.S. adults — sometimes without noticeable symptoms.  

AFib is a highly treatable type of heart arrhythmia, or irregular heart rhythm.

Atrial fibrillation symptoms

For some people, atrial fibrillation symptoms may include heart palpitations, fatigue, chest pain or shortness of breath. For other people, AFib causes no symptoms at all. As a result, many people may have AFib and don’t realize it.

AFib diagnosis

Your physician can diagnose AFib using an electrocardiogram, a test that records your heart’s electrical signals. The results can show if you have AFib or another heart arrhythmia, the medical term for an irregular heartbeat.

AFib risk factors

“The primary risk factors for atrial fibrillation align with key health factors commonly recognized to cause stress and strain on the heart,” said Shivang Shah, MD, a cardiac electrophysiologist at Franciscan Physician Network Indiana Heart Physicians in Indianapolis.

Aging and AFib

As you age, the risk of developing AFib increases.

“Patients in their 30s and 40s have less than a 1 percent chance of having atrial fibrillation,” Dr. Shah said. “But by the time a person enters their eighth decade, the chances increase to about 15 percent.” 

Health conditions linked to AFib

Other health conditions can also increase your risk of developing AFib. These include:

• Coronary artery disease
• Diabetes
• Heart failure
• High blood pressure (hypertension)
• Hyperthyroidism (overproduction of thyroid hormones)
• Lung disease, including chronic obstructive pulmonary disease (COPD) and asthma
• Obstructive sleep apnea
• Previous illness, including sepsis or severe COVID-19
• Prior heart attack
• Surgery recovery

Other atrial fibrillation risk factors

If you consume a large amount of alcohol, have smoked for more than 10 years or have a family history of AFib, you are at an increased risk for atrial fibrillation.

AFib may also develop from a lack of physical activity, or conversely, from years of extreme, high-intensity exercise training.

Can AFib Cause A Stroke?

Stroke is one of the most serious complications caused by AFib. Irregular heartbeats can lead to the formation of blood clots in the heart. If these clots move out of the heart to the brain, they can block the blood supply and cause a stroke.

According to the CDC, strokes caused by of AFib tend to be more severe than strokes caused by other factors.

“As it relates to women in particular, women generally have a higher incidence of stroke as it relates to atrial fibrillation,” said Philip George Jr., MD, cardiac electrophysiologist at Franciscan Health Indianapolis. “Their risk is slightly higher compared to men. And for that reason, we generally want to be a little bit more proactive”

The CDC estimates that AFib causes 1 in 7 strokes. Put another way: having AFib increases the likelihood of having a stroke by five times, compared to people without the condition. 

This risk occurs because in patients with AFib, the atria (the heart’s upper chambers) fail to move blood properly. This malfunction allows blood to pool in the heart and form clots, which can then travel to the brain and cause a stroke. 

For patients with AFib, managing stroke risk is key. New treatments can help. 

Can You Prevent Strokes If You Have AFib?

AFib stroke prevention centers on treating AFib promptly. When we detect and treat AFib, we can prevent most strokes.

“The cornerstone of therapy is stroke risk reduction," said Manoj Duggal, MD, a cardiac electrophysiologist and electrophysiology medical director at Franciscan Health Crown Point.

Lifestyle Changes To Treat Afib And Reduce Stroke Risk

Lifestyle modifications can help keep your heart healthy and manage your symptoms. Remember that living a healthy lifestyle positively impacts your heart and AFib symptoms.

Some tips to help you get started:

• Maintain a healthy weight because extra weight can strain the heart and worsen your symptoms.
• Get regular exercise to improve your overall heart health and regulate heart rhythms.
• Eat a heart-healthy diet full of vegetables, fruits, whole grains and lean proteins.
• Reduce the amount of salt, added sugar, and processed foods in your diet.
• Limit or avoid alcohol.

• Stop smoking

Heart Medicines For Afib May Reduce Stroke Risk

If you have atrial fibrillation, you might receive prescriptions for medications to help control your heart rate and heart rhythm or to reduce the chance of blood clots forming.

Heart specialists often use anticoagulation medications (or blood thinners) to help manage AFib.

Anticoagulant medications (blood thinners) can help reduce AFib-related stroke risk. They improve blood flow and reduce the body’s ability to form blood clots. Additionally, your provider may recommend additional drugs to help bring your heart rate and heart rhythm into normal ranges.

“Generally speaking, if patients are at an elevated risk of stroke, the best way that we can reduce that risk is by making sure that patients are on blood thinners,” said Dr. George. “That's really the best way that we can help to reduce that risk.”

Doctors continue to use older heart medications like warfarin (Coumadin), but there are newer anticoagulation medications that don't require blood draws to monitor the effectiveness of the drug. These drugs reduce the likelihood of experiencing potentially dangerous blood clots within the heart that may cause a stroke.

But blood thinners are not safe for everyone.

“Some patients cannot take blood thinners because of a history of bleeding or because they are at high risk for bleeding,” Dr. Duggal said. For these patients, surgical procedures may be the best option. Other patients may benefit from direct cardioversion. This simple, painless procedure uses medication or a mild electrical shock to restore a normal rhythm.

Medical Procedures To Treat AFib And Reduce Stroke Risk

If you need support beyond medication, your doctor may recommend minimally invasive treatments for your atrial fibrillation. With proper treatment, most people with AFib can enjoy a long and active life.

Franciscan Health providers offer a range of highly effective medical procedures to help treat AFib and reduce AFib-related stroke risk. These include:

• Cardioversion: This simple, painless procedure uses medication or a mild electrical shock to restore the heart’s normal rhythm
• Ablation for AFib: Cardiac ablation is a minimally invasive procedure that blocks irregular heart rhythms by strategically creating scar tissue on the heart.
• Implantable devices: Pacemakers or implantable cardioverter defibrillators (ICDs) help regulate heartbeat rhythm and speed
• Left atrial appendage closure: Using the left atrial appendage occluder (LAAO) device, a minimally invasive procedure seals off the left atrial appendage of the heart, the area where most AFib-related blood clots form

What happens in ablation for AFib?

Ablation is a process that targets and destroys the faulty portions of the heart that trigger irregular rhythms.

“With ablation, we create a bit of scar tissue in the atrium to block abnormal impulses from triggering AFib,” Dr. George said.

Franciscan Health’s heart teams offers all the latest cardiac ablation methods to treat AFib. These include:

• Radiofrequency ablation (RFA): Scars heart tissue with heat 
• Cryoablation: Scars heart tissue with extreme cold
• Microwave ablation: Forms scars with microwaves
• Pulsed field ablation (PFA): Uses short bursts of electricity to destroy abnormal heart tissue
• Surgical ablation: Surgically destroys abnormal heart tissue

“We began using PFA at Franciscan in 2024, and the outcomes have been excellent,” said Dr. George. “It delivers high voltage over a short duration and creates scar tissue with little risk of injury.”

“PFA has helped us treat patients more quickly and shorten wait times. I expect it will soon become the main ablation method we use for AFib,” he added. 

What happens in left atrial appendage occlusion (closure)?  

The left atrial appendage occlusion (LAAO) procedure reduces AFib-related stroke risk by closing off the area of the heart where blood clots are most likely to form.  

During the minimally invasive LAAO procedure, surgeons implant a device to close off the left atrial appendage of the heart permanently. They direct the device into the heart via a catheter inserted into a vein in the leg. Once in place, the device prevents blood flow into the appendage and prevents blood clots from forming there. 

“With left atrial appendage closure, we can close the pocket of the heart most at risk for developing blood clots,” said Saeed R. Shaikh, MD, interventional cardiologist at Franciscan Health Indianapolis. “In most cases, patients no longer need blood thinners and are still protected from stroke, following the procedure.”

Franciscan Health offers two FDA-approved LAAO devices: the WATCHMAN™ Implant and the Amplatzer™ Amulet™. With nearly 600 procedures expected in 2025, Franciscan’s program is among the largest in the region.

“Our success rate is 99 percent, and the complication risk is only 0.5 percent,” said Dr. Shaikh. "The LAAO procedure is a very safe and effective means to reduce the risk of AFib-related stroke.”

Access Advanced AFib Care At Franciscan Health

AFib is highly manageable, thanks to a wide range of effective AFib treatment options. You can lower your risk of stroke when you understand and manage your AFib. 

If you have AFib, our care teams will work with you to craft a tailored treatment plan to reduce your stroke risk and restore a normal heart rhythm. Learn more about Franciscan Health’s atrial fibrillation care and explore our heart and vascular services.