Atrial Fibrillation (A Fib) Prognosis

In general, the outlook for most individuals with A fib is good to fair, depending on the cause of the disease and how well the patient responds to treatment. The most dangerous complication of atrial fibrillation is stroke.

  • Someone with atrial fibrillation is about 3-5 times more likely to have a stroke than someone who does not have atrial fibrillation.
  • The risk of stroke from atrial fibrillation for people aged 50-59 years is about 1.5%. For those aged 80-89 years, the risk is about 30%.
  • Warfarin (Coumadin), when taken in appropriate doses and monitored carefully, reduces this risk of stroke by over two-thirds.
  • It is important to know that clinical trial data have shown that individuals can live just as long with atrial fibrillation with a controlled heart rate — for example, with medications plus Coumadin — as other people in normal sinus rhythm (AFFIRM trial).

Another complication of atrial fibrillation is heart failure.

  • In heart failure, the heart no longer contracts and pumps as strongly as it should.
  • The very rapid contraction of the ventricles in atrial fibrillation can gradually weaken the muscle walls of the ventricles.
  • This is uncommon, however, because most people seek treatment for atrial fibrillation before the heart begins to fail.

Patients with complications of stroke or heart failure have a more guarded outcome than those without complications. However, for most people with atrial fibrillation, relatively simple treatment dramatically lowers the risk of serious outcomes. Those who have infrequent and brief episodes of atrial fibrillation may need no further treatment other than learning to avoid the triggers of their episodes, such as caffeine, alcohol, or overeating.

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