On this page:
- How is stroke risk assessed?
- Blood-thinning medications to reduce your risk of stroke with AF
- What else can I do to reduce my risk of stroke?
- Treating an irregular heartbeat
If you have AF, your doctor will discuss with you whether you need treatment to reduce your risk of stroke. The main treatment is a blood-thinning medication called an anticoagulant.
You may also be offered treatment to help your heart beat more effectively. This can include medication or surgical procedures to restore heart rhythm.
How is stroke risk assessed?
Doctors assess your stroke risk using a scoring system called CHA2DS2-VASc. This can help you and your doctor to decide on your treatment together.
The CHA2DS2-VASc scale
| Factor | Score |
|---|---|
| Congestive heart failure | 1 |
| High blood pressure | 1 |
| Age Over 75 65–74 Under 65 | 2 1 0 |
| Diabetes | 1 |
| Previous stroke, transient ischaemic attack (TIA) or thromboembolism | 2 |
| Vascular disease | 1 |
| If you are female | 1 |
The CHA2DS2-VASc scoring system is a list of things that make you more at risk of stroke. If you are a man with a score of one or more, or a woman with a score of two or more, your doctor will usually discuss the use of a blood-thinning (anticoagulant) medication to reduce your risk of stroke. If you are a man with a score of zero, or a woman with a score of one, you may not need any blood-thinning treatment, as the risk of treatment will outweigh the benefits.
Blood-thinning medications to reduce your risk of stroke with AF
Anticoagulant medications are the main treatment given to reduce your risk of stroke with atrial fibrillation. They reduce your risk of stroke by slowing down the clotting process and making a clot less likely to form.
Our blood-thinning medication webpage has more information on the different types of anticoagulant, the benefits and risks and possible side effects.
What else can I do to reduce my risk of stroke?
There are many things you can do to lower your chances of having a stroke. These include:
- Managing any other medical conditions you have, for example high cholesterol, high blood pressure or diabetes.
- Stopping smoking.
- Limiting the amount of alcohol you drink.
- Following a healthy diet.
- Exercising regularly.
Treating an irregular heartbeat
On top of treatment to reduce your stroke risk, you may have treatments to improve your heart rate and rhythm control. You may be treated by your GP, or you might be referred to a specialist doctor called a cardiologist.
Heart rate control
If your heart beats too fast (over 100bpm resting heart rate), you may need medication to slow your heart rate. Medications include beta blockers, rate-limiting calcium channel blockers and digoxin. If you cannot use medication, you might be offered a heart pacemaker.
Heart rhythm control
If an irregular heart rhythm is causing symptoms, you may be offered electrical cardioversion treatment. This is a non-surgical therapy. It uses a controlled electric shock to restore a normal rhythm.
Irregular heartbeat can also be treated with medications, including beta blockers and flecainide.
Catheter ablation
If medication does not work, catheter ablation can be used to remove the heart cells which are causing the irregular electrical impulses. This procedure uses thin wires guided through a vein to locate the abnormal electrical activity in the heart. The cells are then destroyed using high-frequency radio waves.
Support with atrial fibrillation
If you need more support with your atrial fibrillation, you can visit the AF Association website or contact their Helpline on 01789 867 502.