Clinical strokes in atrial fibrillation: the tip of the iceberg

Stroke remains a tragic complication in patients with atrial fibrillation (AF) and can lead to significant disability and death.1 In the community, patients with AF are nearly five times more likely to experience a stroke compared witth those without AF.2 Yet, despite the relatively high incidence in patients with AF, there remains uncertainty regarding the mechanisms and causality of AF and stroke.3 In addition, most of our efforts to lower risk of brain injury in patients with AF, whether through non-pharmacological or pharmacological interventions, are founded upon ‘clinical strokes’ or ‘disabling strokes’ as endpoints that probably underestimate the complex nature of brain injuries that are possible.4


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