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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Risk Factor Management and Atrial Fibrillation Clinics: Saving the Best for Last?

Rajiv Mahajan1, Rajeev K Pathak2, Anand Thiyagarajah1

  • 1Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute, University of Adelaide and Royal Adelaide Hospital, Adelaide, SA, Australia.

Heart, Lung & Circulation
|July 1, 2017
PubMed

Insights

Atrial fibrillation (AF) management should include a fourth pillar: targeting modifiable cardiovascular risk factors. Aggressively managing conditions like obesity and diabetes may reverse AF progression and reduce its burden.

Area of Science:

  • Cardiology
  • Preventive Medicine
  • Public Health

Background:

  • Atrial fibrillation (AF) is a primary cause of global cardiovascular morbidity and mortality.
  • Current AF management focuses on anticoagulation, rhythm control, and treating underlying heart disease.
  • Cardiometabolic risk factors are increasingly linked to the rising prevalence of AF.

Purpose of the Study:

  • To propose an integrated care model for AF management.
  • To introduce a fourth pillar of AF care focused on modifiable cardiovascular risk factors.
  • To explore the potential of risk factor management in retarding and reversing AF pathology.

Main Methods:

  • Literature review and synthesis of current AF management strategies.
  • Analysis of the role of cardiometabolic risk factors in AF development.
  • Conceptual framework development for integrated AF care.

Main Results:

  • Cardiovascular risk factors such as obesity, hypertension, diabetes mellitus, and obstructive sleep apnea contribute to AF.
  • Targeting these modifiable factors can be integrated into AF care.
  • Risk factor management may slow or reverse pathological processes underlying AF.

Conclusions:

  • A comprehensive, integrated approach to AF care is essential.
  • Aggressively managing cardiometabolic risk factors represents a crucial, yet often overlooked, component of AF treatment.
  • This expanded model has the potential to significantly reduce the AF burden and improve patient outcomes.

Keywords:
Atrial fibrillationAtrial remodellingCardiovascular risk factors

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