Beyond CHA₂DS₂-VASc in atrial fibrillation: the atrium and the risk of stroke

Pathology affecting the atria have a significant impact on the occurrence of arrhythmias and the risk of stroke. The causal relationship between atrial fibrillation (AF) and ischaemic stroke has been challenged by the recent uncovering of the lack of temporal association between thrombo-embolic cerebral events and paroxysmal AF or tachycardia. General conditions, such as the one considered in the definition of the CHA₂DS₂-VASc score, or specific atrial pathology (also independently occurring), could predispose to cerebral embolism.