Atrial fibrillation pearls

1. AF increases the stroke risk by 5-6 times
2. In presence of heart disease AF increases stroke risk 15 times
3. 10 % of stroke patients will be found to have AF
4. Europeans found 14 % silent stroke rate in AF patients.
5. In Oxfordshire, 30 day mortality for stroke with AF is 23 %, 8 % without
6. Presence of AF increases health spending 15-29 times
7. Lone AF depends on age, risk of 0.5 % ages 50-59, 9 % ages 80-89
8. Risk is higher in patients with HTN, DM, elderly and prior stroke
9. Presence of murmur or any heart disease precludes a diagnosis of lone AF
10. TEE may not be needed if clinical neurologic symptoms prove need for anticoagulation
11. Warfarin may lower risk of stroke in susceptible patients by 80%
12. Anticoagulate for 3-4 weeks before and after cardioversion, consider a TEE before