Atrial fibrillation (AFib) is a heart rhythm disorder that increases your risk of stroke fivefold. With AFib, the two upper chambers of your heart beat irregularly, allowing blood to pool and form clots that can dislodge and travel to your brain and other organs. The good news is that up to 80 percent of strokes in people who have AFib can actually be prevented.

The AFib-stroke connection

Understanding that AFib puts you at higher risk of stroke is extremely important. You may not have any symptoms of AFib, or you may experience things like shortness of breath, fluttering in your chest, and rapid heart rate. Regardless, around 15 percent of people who have strokes also have AFib. Of those people, up to 70 percent may die from complications.

Your doctor can help you manage your stroke risk by suggesting different lifestyle changes and medications. You may even want to ask some questions so you can understand your condition and its risks better.

Questions to ask your doctor

Don’t know where to start? Here are some ideas that may help.

Do any of my other health conditions increase my stroke risk?

AFib in combination with other health conditions may increase your risk of stroke. These conditions include high blood pressure, diabetes, and history of stroke or heart failure. Being of advanced age is another factor that can increase your risk.

What lifestyle changes may help lower my risk of stroke?

There are many things you can do at home to lessen your risk of stroke:

  • Maintain a healthy weight.
  • Exercise.
  • Eat a healthy diet.
  • Control other health issues, like heart disease and diabetes.
  • Stop smoking.
  • Monitor your blood pressure.

Your doctor may suggest a diet and exercise routine that can help you achieve some of these lifestyle goals. If not, they may be able to refer you to a specialist or to different resources within your community that can, for example, help you stop smoking.

What medications may help me?

Anticoagulants, like warfarin (Coumadin), are often prescribed to lower stroke risk. They work by thinning the blood to reduce clotting that can lead to stroke. They’re also called blood thinners. You may or may not have tried blood thinners in the past. They’re often prescribed for people who have AFib and another condition, like heart disease, that can increase stroke risk.

Ask your doctor to explain the different types of medications. Some are long-lasting, while others, like dabigatran (Pradaxa), act for only a short period of time.

What monitoring might I need while on medications?

Warfarin may lead to dangerous bleeding. While you’re on it, you’ll need to have your blood tested regularly to monitor the medication’s effect. The shorter-lasting medications may also require monitoring.

Your doctor will give you instructions on use and any guidelines for when you need to have your blood checked. In addition, some people may need to change their use of medications if they have procedures that involve bleeding, like surgery or a dental procedure.

What side effects might I experience?

Anticoagulant medications do carry some side effects you need to know about. Your blood won’t clot as easily while taking these drugs. So cutting yourself may be dangerous if you can’t stop the bleeding. You may experience anything from bleeding gums to heavy menstrual periods to diarrhea. More serious side effects include dizziness, severe stomach pain, and bruising without injury.

You may be more likely to experience side effects if you’re over age 75 or if you take multiple blood-thinning medications. High blood pressure, kidney issues, and alcoholism are other factors that may mean more side effects. So are a history of stroke, cancer, and liver disease.

Are there treatment options besides blood thinners? Am I a candidate?

There are implant devices, like the WATCHMAN, that may reduce your dependency on blood-thinning drugs. They work by closing off what is called the left atrial appendage in your heart where clots often form. These devices are likely an option for you if your AFib isn’t caused by heart valve problems and if you can take short-acting warfarin.

Your doctor can give you a better idea of success with implants. As many as nine out of 10 people are able to stop taking warfarin 45 days after having the procedure.

Symptoms of stroke

You may also want to discuss the symptoms of stroke with your doctor in detail. Every minute counts when it comes to treating your stroke and preventing brain damage. Familiarize yourself with the symptoms and ask your doctor when you should call the medical office versus calling 911 for immediate medical help.

Symptoms of stroke include:

  • difficulty speaking or understanding
  • numbness or paralysis, especially on one side of your body
  • vision issues with one or both eyes
  • headache, vomiting, or dizziness
  • coordination issues or trouble balancing

Your doctor may tell you that your friends and family members should act “FAST” if they suspect you’re having a stroke. This means that they should observe your face, arms, and speech, and contact 911 in a timely manner. Ask your doctor if there are any pamphlets or other resources you can give to your loved ones so they can learn more to help in case of emergency.

The takeaway: Talk with your doctor

Understanding the risks and complications of AFib can help you prevent a stroke. Reach out to your doctor if you have questions. Don’t feel shy or embarrassed about asking too many. If you have trouble remembering what you want to ask, jot it down in a notebook before your appointment. Bring a pen to your appointment so you can also write down the answers your doctor gives you. The more information you know, the better your chance of preventing a stroke.