Related Experiment Video
Updated: Jun 29, 2025
Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Atrial Fibrillation and Early Vascular Aging: Clinical Implications, Methodology Issues and Open Questions-A Review
Giacomo Pucci1,2, Andrea Grillo3, Kalliopi V Dalakleidi4
1Unit of Internal Medicine, Santa Maria University Hospital, 05100 Terni, Italy.
Insights
Vascular aging (VA) predicts atrial fibrillation (AF) incidence, but its role in modifying cardiovascular event risk in AF patients is unclear. Current VA measurement tools cannot detect AF, missing opportunities for cardiovascular prevention.
Area of Science:
- Cardiology
- Vascular Biology
- Gerontology
Background:
- Atrial fibrillation (AF) is a common arrhythmia linked to adverse cardiovascular (CV) outcomes.
- Vascular aging (VA), the deterioration of arterial health, independently predicts AF and CV events.
- Early identification and treatment of VA may reduce AF and CV event risk.
Purpose of the Study:
- To review the literature on the relationship between vascular aging and atrial fibrillation.
- To address key questions regarding VA biomarkers, prediction of AF, risk modification in AF patients, and AF detection during VA measurements.
Main Methods:
- A network of scientists and clinicians conducted a narrative literature review.
- Focused on five key questions concerning VA and AF.
- Synthesized existing research to identify knowledge gaps.
Main Results:
- Vascular aging is a strong, independent predictor of AF incidence.
- The role of VA as a risk modifier for CV events in AF patients is debatable.
- Data on VA measurement reliability with AF-related rhythm irregularities are limited and inconclusive.
- No current devices can detect AF during VA measurements, representing a missed prevention opportunity.
Conclusions:
- VA is a significant predictor of AF incidence.
- Further research is needed to clarify VA's role in CV risk modification for AF patients.
- Developing integrated VA measurement and AF detection devices is crucial for cardiovascular prevention in high-risk individuals.
Abstract:
Atrial fibrillation (AF), the most common cardiac arrhythmia, is associated with adverse CV outcomes. Vascular aging (VA), which is defined as the progressive deterioration of arterial function and structure over a lifetime, is an independent predictor of both AF development and CV events. A timing identification and treatment of early VA has therefore the potential to reduce the risk of AF incidence and related CV events. A network of scientists and clinicians from the COST Action VascAgeNet identified five clinically and methodologically relevant questions regarding the relationship between AF and VA and conducted a narrative review of the literature to find potential answers. These are: (1) Are VA biomarkers associated with AF? (2) Does early VA predict AF occurrence better than chronological aging? (3) Is early VA a risk enhancer for the occurrence of CV events in AF patients? (4) Are devices measuring VA suitable to perform subclinical AF detection? (5) Does atrial-fibrillation-related rhythm irregularity have a negative impact on the measurement of vascular age? Results showed that VA is a powerful and independent predictor of AF incidence, however, its role as risk modifier for the occurrence of CV events in patients with AF is debatable. Limited and inconclusive data exist regarding the reliability of VA measurement in the presence of rhythm irregularities associated with AF. To date, no device is equipped with tools capable of detecting AF during VA measurements. This represents a missed opportunity to effectively perform CV prevention in people at high risk. Further advances are needed to fill knowledge gaps in this field.
