Should atrial fibrillation be considered a vascular disease? The need for a comprehensive vascular approach

Area of Science:

• Cardiology
• Vascular Medicine
• Systemic Diseases

Background:

• Atrial fibrillation (AF) is often viewed in isolation, but it presents significant systemic implications.
• Patients with AF face residual stroke risks and other comorbidities.
• AF is increasingly recognized as a complex vascular condition.

Purpose of the Study:

• To review the role of atrial fibrillation as a systemic vascular disease.
• To advocate for a holistic management approach in AF patients.
• To emphasize vascular protection beyond anticoagulation.

Main Methods:

• Literature review on atrial fibrillation as a systemic vascular disease.
• Analysis of AF's impact on various vascular beds and systemic pathways.
• Synthesis of expert opinion on comprehensive AF management.

Main Results:

• Atrial fibrillation is linked to stroke, cognitive impairment, atherosclerotic disease, and chronic kidney disease.
• AF involves hemodynamic and systemic changes like inflammation, oxidative stress, and endothelial dysfunction.
• A significant residual stroke risk persists despite anticoagulation.

Conclusions:

• Atrial fibrillation should be treated as a systemic vascular disease requiring a holistic approach.
• Management must extend beyond stroke prevention to include complete vascular protection.
• Comprehensive care addresses the multifaceted nature of AF and its associated risks.