Keywords: stroke, atrial fibrillation, oral anticoagulation. 1. Introduction. Stroke is a severe and devastating disease affecting more than 12 million people worldwide every year . One of the main risk factors for ischemic stroke (IS) is atrial fibrillation (AF). atrial enlargement, hyperlipidemia, high CHA 2 DS 2-VASc score, and increased , Lowering stroke risk. People with AFib are at a higher risk of stroke — about 1 in 7 strokes are AFib related — due to clots that can form in the upper chambers of the heart. Of the strokes resulting from atrial fibrillation, 90% occur from clots originating in the left atrial appendage in the left atrium of the heart., Research says there's a direct link between atrial fibrillation (AFib) and stroke. Studies say that atrial fibrillation is the direct cause of 1 in 4 strokes in people older than 80 years old., Atrial fibrillation, also known as Afib, is an irregular heartbeat where the heart's upper chambers beat at around 400 beats a minute, quivering instead of beating steadily. "At that speed, the heart doesn't contract very well," says Paari Dominic, MBBS, MPH, adult cardiac electrophysiologist at University of Iowa Health Care. "It just quivers , Ischemic strokes related to atrial fibrillation are highly prevalent, presenting with severe neurologic syndromes and associated with high risk of recurrence. Although advances have been made in both primary and secondary stroke prevention for patients with atrial fibrillation, the long-term risks for stroke recurrence and bleeding complications from antithrombotic treatment remain substantial , And an irregular atrial heart rhythm — a condition called atrial fibrillation — accounts for an estimated 15% of all strokes in the United States. Stroke is a leading cause of death in America. It happens when a blood vessel that supplies blood to the brain is blocked or bursts..