OBJECTIVES: This study investigates stroke risk and the association with health-related quality of life (HRQoL), and resource use among diagnosed atrial fibrillation (AF) patients.  METHODS: The study included data from the EU 2010 (N=57,805) National Health and Wellness Survey, a self-administered, internet-based questionnaire from a demographically representative sample of adults (aged ≥18) in 5EU. Stroke risk was assessed with CHA2DS2-VASc, an index summing the presence of congestive heart failure, hypertension, age ≥ 75 (2 points), diabetes mellitus, previous stroke/transient ischemic attack (2 points), vascular disease, age 65-74, and female gender.  Low- (CHA2DS2-VASc = 0), moderate- (1), and high- (2+) risk patients reported on measures of HRQoL (mental (MCS), physical component summary (PCS) and SF-6D (health utility) scores from the SF-12v2), and health care resource use. RESULTS: Among 479 diagnosed AF respondents (prevalence of 0.93%), 15.1% were low, 27.9% moderate, and 57.0% high risk for stroke. Significant differences exist in the use of anticoagulant medication for stroke prevention among low- (38.9%) vs. moderate- (54.9%), and high- (59.8%) risk patients, p<0.05.   High-risk patients reported significantly lower levels of HRQoL relative to low-risk patients (PCS: 37.1 vs. 41.3; Utilities: 0.65 vs. 0.70, p<.05). The number of hospitalizations and physician visits  in the past 6  months were also significantly higher for high-risk patients compared with both low-risk and moderate-risk patients (hospitalization: high- (0.43) vs. moderate- (0.26) and low-risk (0.14), p<0.05)  CONCLUSIONS: In 5EU, 40% of AF patients at high-risk of stroke are not taking anticoagulant medication. Being high-risk for stroke can be a substantial burden on AF patients, reducing their HRQoL, after accounting for demographics, patient characteristics, and comorbidities.  Increased number of hospitalizations and physician visits suggests that these AF patients can place a substantial burden on the healthcare system. There remains an unmet need for enhanced treatment of high-risk AF patients.