Anticoagulation UK

Atrial fibrillation (AF)

Atrial fibrillation (AF) is a type of irregular heartbeat. It is the most common heart rhythm abnormality in the UK and if it is not managed properly, can increase the risk of having a stroke by five times

In Atrial Fibrillation, blood may pool (stagnate) in the chambers of the heart.

This can happen because of the inefficient pumping in the upper chambers of the heart.

When this happens blood clots can form in the heart chambers. If they break off, they can travel in the blood supply to the brain where they cause a stroke.

This type of stroke is called an ischemic stroke.



Types of Atrial Fibrillation

Paroxysmal AF – comes and goes and usually stops within 48 hours without any treatment

Persistent AF – episodes last longer that seven days or less when treated

Longstanding persistent AF – continuous for a year or longer

Permanent AF – present at all times and no more attempts to restore normal heart rhythm will be made

Symptoms may include:

  • Dizziness
  • Shortness of breath
  • Irregular or fast heart beat
  • Tiredness
  • Chest pain (angina)
  • Low blood pressure
  • Heart failure


Some people do not experience any symptoms and the condition is only diagnosed during routine tests or investigations.

AF increases your risk of having a stroke by 5 times

If you have been told you have AF yours doctor should actively look to reduce your risk of stroke as well as treat the symptoms of AF. Anticoagulants are prescribed as a preventative measure to reduce the risk of blood clots developing.

Oral anticoagulants include:

  • Apixaban - factor Xa inhibitor
  • Edoxaban - factor Xa inhibitor
  • Dabigatran - direct thrombin inhibitor
  • Rivaroxaban - factor Xa inhibitor
  • Warfarin – Vitamin K Antagonist (VKA)

Anticoagulant therapy does not treat the symptoms of AF but helps to reduce your risk of stroke.

Stroke is a serious medical condition that occurs when the blood supply to part of the brain is cut off. It can affect our bodily functions, thought processing, ability to learn, communication and emotions.

Signs may vary from person to person and symptoms will depend on which part of your brain has been affected by a clot or bleed but may include:

  • Face – may drop on one side and eye and mouth may have drooped
  • Arms – inability to move arms due to arm weakness or numbness
  • Speech – slurred, garbled or unable to talk
  • Inability to move or use your arm and leg on one side of the body
  • Loss of vision
  • Dizziness
  • Problems with balance and coordination
  • Difficulty in swallowing

Recognise the symptoms using the FAST test

FACE weakness:

Can the person smile? Has their mouth or eye drooped?

ARM weakness:

Can the person raise both arms?

SPEECH problems:

Can the person speak clearly and understand what you say?

TIME to call 999