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 FAQs A-Fib Drug Therapy: A-Fib Stroke 

Drug Therapies for Atrial Fibrillation, A-Fib, Afib

“Why is an A-Fib stroke often worse than other causes of stroke. If a clot causes a stroke, what difference does it make if it comes from A-Fib or other causes? Isn’t the damage the same?”

When we refer to an A-Fib stroke, we are talking about an ischemic stroke. An ischemic stroke is caused by a clot which obstructs blood flow to the brain (versus a hemorrhagic stroke when a weakened blood vessel ruptures).

Several research studies have compared ischemic stroke patients with A-Fib against those without A-Fib. A-Fib stroke patients were associated with more widespread deprivation of blood supply to the brain, more extensive growth of dead tissue areas (from failure of blood supply), more rapid and severe deterioration, and higher mortality rate. In addition, outcomes were worse for patients with a longer duration of Atrial Fibrillation.

A-Fib strokes may be worse because of the larger size of the clots. Most (95%) of A-Fib strokes originate with clots from the Left Atrial Appendage (LAA). Clots that form in the LAA can be quite large and completely block blood vessels in the brain often resulting in death or severe neurologic damage.

References for this article
Seet RC, Zhang Y, Wijdicks EF, Rabinstein AA. Relationship between chronic atrial fibrillation and worse outcomes in stroke patients after intravenous thrombolysis. Arch Neurol. 2011 Nov;68(11):1454-8. doi: 10.1001/archneurol.2011.248. PubMed PMID: 22084129. URL: http://www.ncbi.nlm.nih.gov/pubmed/22084129.

Tu HT, et al. for the EPITHET-DEFUSE Investigators. Worse stroke outcome in atrial fibrillation is explained by more severe hypoperfusion, infarct growth, and hemorrhagic transformation. Int J Stroke. 2013 Mar 12. doi: 10.1111/ijs.12007. [Epub ahead of print] PubMed PMID: 23489996; PubMed Central PMCID: PMC3688700

Return to FAQ Drug Therapies
Last updated: Monday, June 18, 2018

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