When it comes to stroke, people immediately associate it with a problem with the blood vessels in the brain. It is not known that a large proportion of strokes in the elderly are caused by atrial fibrillation, so it is important to understand and pay sufficient attention to atrial fibrillation in the elderly, as well as strokes caused by atrial fibrillation. The incidence of atrial fibrillation and its hazards: Atrial fibrillation (atrial fibrillation for short) is a common disease in the elderly, and the prevalence increases with age. There is one patient with atrial fibrillation for every 25 people aged ≥ 60 years, and one patient with atrial fibrillation for every 10 people aged ≥ 80 years. There are currently about 8 million patients with atrial fibrillation in China, and atrial fibrillation has become an “epidemic” in the 21st century. Stroke is one of the main complications of atrial fibrillation patients, about 90% of fibrillation embolism is a complication of cerebral embolism, and 20% of ischemic stroke is caused by atrial fibrillation. Patients with atrial fibrillation are very prone to atrial thrombus, which is basically located in the left ear of the heart, and when the heart beats, the thrombus in the ear is easily dislodged, which in turn leads to stroke, heart and kidney infarction and other important organs. According to statistics, the prevalence of stroke in patients with atrial fibrillation is 6 to 8 times higher than that of non-atrial fibrillation population, up to 13.9%. Atrial fibrillation is one of the diseases that seriously endanger health and is an important cause of death and disability in middle-aged and elderly people. The consequences of stroke caused by atrial fibrillation are very serious and are associated with high mortality and paralysis rates, with a 50% chance of death in a year. In addition, patients with atrial fibrillation can cause sudden death due to ventricular fibrillation, because the bioelectric frequency of atrial fibrillation is between 300 and 600 beats/min, and if it travels to the ventricles at 1:1, then the patient will die from ventricular fibrillation. Therefore, the mortality rate of patients with atrial fibrillation is 2 to 4 times higher than normal. Paroxysmal atrial fibrillation also carries a high risk of stroke: It was previously thought that although paroxysmal atrial fibrillation carries a high risk of cerebral embolism during the acute phase of the attack, it does not carry a high risk of causing a stroke during the remission phase. A growing number of studies in recent years suggest that the risk of stroke from paroxysmal AF is as high as that from persistent AF. A study of 3890 patients with various types of atrial fibrillation showed that the incidence of ischemic stroke at 1 year follow-up was 1.3% for first diagnosis of atrial fibrillation, 1.9% for paroxysmal atrial fibrillation, and 1.6% for persistent atrial fibrillation. It can be seen that the risk of stroke due to paroxysmal atrial fibrillation is similar to that of persistent atrial fibrillation. Cryptogenic strokes may be caused mainly by paroxysmal atrial fibrillation. About 20% to 40% of ischemic strokes have an undetermined cause, but studies suggest that most are due to cardiogenic cerebral embolism. A study in the American Journal of Neurology showed that cryptogenic strokes are mainly caused by paroxysmal atrial fibrillation. In this study, patients with cryptogenic stroke or cryptogenic transient ischemic attack (TIA) within 3 months of onset were monitored for atrial fibrillation using a portable telecardiogram recorder, and a total of 23% of patients were found to have atrial fibrillation during the 21-day monitoring period, with 85% having atrial fibrillation of less than 30 seconds duration and 15% having atrial fibrillation of 4 to 24 hours duration. Patients with asymptomatic cerebral infarction have a 2-fold increased risk of developing AF: It is well established that patients with asymptomatic cerebral infarction are at least 5 times more likely than those with symptomatic cerebral infarction, and patients with asymptomatic cerebral infarction have an approximately 3-fold increased risk of symptomatic cerebral infarction and an approximately 2.3-fold increased risk of vascular dementia than subjects with normal brain magnetic resonance imaging (MRI) examinations. The study reported that in a “healthy” population with a mean age of 62 years (53% female), 10.7% of subjects who underwent brain MRI had asymptomatic cerebral infarction, including 84% with a single cerebral infarct lesion, and that patients with asymptomatic cerebral infarction had a 2-fold increased risk of atrial fibrillation compared to subjects with normal brain MRI. Treatment of atrial fibrillation and stroke prevention: In general, patients with atrial fibrillation need to quit smoking, limit alcohol consumption, and avoid caffeine-containing substances such as tea, coffee, cola, and some over-the-counter medications to reduce the incidence of atrial fibrillation. Anticoagulation in patients with atrial fibrillation can prevent stroke: All patients with atrial fibrillation should receive antithrombotic therapy unless they have a contraindication. Warfarin anticoagulation therapy (INR of 2.0 to 3.0) or aspirin (81 to 325 mg/d) is available, with warfarin being preferred. Warfarin anticoagulation therapy reduces the relative risk of stroke, avoiding 1 serious vascular event for every 37 cases treated for 1 year. Minimally invasive surgery can completely cure atrial fibrillation and prevent stroke: Minimally invasive surgery (two holes of 1~2 cm in size) cures all types of atrial fibrillation with a high cure rate (about 93%), while the left heart ear, the origin of stroke, is removed intraoperatively, eliminating all kinds of left heart ear thrombosis, cerebral embolism and stroke, which is The most effective treatment method at present.