Prognosis of individuals with atrial fibrillation.

Patients with AF have a mortality rate about twice that of age-and sex-matched individuals without AF, and a stroke rate that is about fivefold greater. Patients less than 60 years of age with lone AF have an extremely low risk of stroke. Patients less than 65 years of age who do not have diabetes, a history of hypertension, a previous TIA or stroke, or heart failure have an annual risk of stroke of about 1% per year. Unfortunately, patients older than 65 or younger patients with any of the four risk factors have an annual risk of stroke of 4% or greater. Transthoracic and transesophageal echocardiography may be able to refine the risk stratification further, but additional studies are needed to establish their role.