Prognosis

Recurrence

Recurrent symptomatic attacks are common in patients with paroxysmal AF ^b
Few patients with chronic AF remain in sinus rhythm long-term following cardioversion. ^a  
Patients are more likely to revert to AF if they

• had AF for more than 3 months ^a  
• have severe heart failure ^a  
• are old ^a  

Anti-arrhythmic side-effects are common ^a  

Stroke

Atrial fibrillation is an important risk factor for stroke. ^a  
The risk of stroke is increased further with

• a history of hypertension ^a  
• previous TIA or stroke ^a  
• ischaemic heart disease ^{a b}  
• diabetes mellitus ^a  
• recent heart failure ^a  
• increasing age ^a  

• markers of LV dysfunction ^a  
• cardiomegaly  ^b  

Clinical prediction rule to rank your patient's risk of a stroke

CHAD-2 stroke risk factors b	Score
Congestive hear failure	+1
Hypertension	+1
Aged 75 or older	+1
Diabetes mellitus	+1
History of stroke or transient ischaemic attack	+2

Risk of a stroke 

Score b	Risk of a stroke
0 to 2	low
3 to 5	medium
6	high

Patients with atrial fibrillation who have a stroke are at increased risk of having a severe stroke or dying ^a  

Peripheral thromboembolism

Atrial fibrillation increases the risk of peripheral thromboembolism. ^b  
The risk is increased with

• younger age at onset of AF ^b 
• peripheral atheroscelosis ^b