Non-traditional risk factors for atrial fibrillation: epidemiology, mechanisms, and strategies

Area of Science:

• Cardiology
• Preventive Medicine
• Epidemiology

Background:

• Atrial fibrillation (AF) is a prevalent arrhythmia linked to significant morbidity and mortality.
• Cardiovascular risk factors are key to AF pathogenesis, necessitating early detection and mitigation for primary prevention.
• While traditional risk factors are known, novel factors are increasingly identified.

Purpose of the Study:

• To review emerging non-traditional risk factors for primary prevention of new-onset AF.
• To outline current evidence on associations between non-traditional risk factors and AF.
• To explore potential mechanisms and interventions for AF prevention targeting these factors.

Main Methods:

• Literature review of non-traditional risk factors for atrial fibrillation.
• Analysis of associations between lifestyle, biomarkers, diseases, and environmental factors with AF.
• Exploration of potential intervention strategies and guideline updates.

Main Results:

• Identified non-traditional risk factors include sleep disturbances, night shift work, diet, gut microbiota, hyperuricaemia, homocysteine, depression, epilepsy, clonal haematopoiesis, infections, asthma, and environmental pollution.
• Many non-traditional factors are less controllable, challenging conventional prevention.
• Evidence on mechanisms linking these factors to AF is evolving.

Conclusions:

• Non-traditional risk factors represent a growing area for AF primary prevention research.
• Targeting these factors requires novel individual and societal interventions.
• Updated guidelines are suggested to incorporate these emerging risk factors for AF prevention.