Personalized Care Approach Emphasizing Lifestyle Factors May Reduce AFib Risk for Specific Individuals
Atrial fibrillation (AF), a common form of arrhythmia or irregular heartbeat, impacts millions globally. Besides well-known risk factors like physical activity, diabetes, obesity, and smoking, the presence of chronic conditions such as cardiovascular, respiratory, metabolic, and mental health disorders also increases the risk of AF.
A recent review published in the Journal of the American College of Cardiology sheds light on lifestyle factors, concurrent medical conditions, and socioeconomic aspects that influence the risk of AF. The findings highlight the significance of multidisciplinary, individualized care to effectively manage AF and reduce the risk of death and other health complications.
Dr. Stephen Tang, a board-certified cardiac electrophysiologist, emphasized that treating AF extends beyond medication or ablation. "This complex disease is driven by numerous risk factors and comorbidities," he said. If uncontrolled, AF can continue to recur even after ablation procedures. Identifying and addressing these contributing factors is essential for long-term AF management.
AF is characterized by an irregular beating of the left upper heart chamber or atrium, which can cause blood clots to form and travel to the brain, potentially causing a stroke. Genetic factors, age, and sex are non-modifiable risk factors for AF, while lifestyle choices, medical conditions, and socioeconomic factors are modifiable risks.
To manage the condition, blood thinners (anticoagulants) can help prevent blood clot formation and reduce the risk of stroke. Drugs like warfarin and nonvitamin K antagonist oral anticoagulants (NOACs) are commonly used for this purpose. Beta-blockers and calcium channel blockers can help control the heart rate. In cases where lifestyle modifications and medications are ineffective, invasive procedures like catheter ablation may be required to restore a normal heart rhythm.
Regular physical activity is associated with a lower risk of AF, while a sedentary lifestyle increases the risk. At least 150 minutes of moderate-to-vigorous exercise a week is recommended to lower the risk of AF. Obesity is another significant risk factor, as it increases the likelihood of AF recurrence and complications. Smoking and moderate-to-heavy alcohol consumption are also associated with an increased risk of AF.
Chronic cardiovascular, respiratory, and mental health conditions are risk factors and complications for AF. For instance, obstructive sleep apnea, a condition characterized by interrupted breathing during sleep, can increase the risk of AF and recurrence after catheter ablation. CPAP machines are helpful for managing sleep apnea and reducing AF risk.
Management and treatment of comorbid cardiovascular conditions such as hypertension can help reduce the risk of AF complications. However, the use of anticoagulants needs to be used cautiously in patients undergoing minimally invasive surgery for coronary artery disease due to the risk of bleeding complications.
Despite evidence linking lifestyle factors and medical conditions to AF, the role of physical activity in preventing stroke remains unclear. Further research is needed to fully understand the link between lifestyle choices, medical conditions, and the risk of AF.
Comorbid conditions and polypharmacy, or the use of five or more medications, can increase the risk of complications in AF patients. Nonvitamin K antagonist oral anticoagulants are associated with fewer adverse events than warfarin in AF patients and can be used with caution.
In addition to lifestyle factors and comorbid conditions, sex, socioeconomic status, and ethnicity/race can influence the risk of AF. Studies suggest that individuals of South Asian and African origin may have a lower risk of AF than the white population. The risk of AF is higher in men than women, but women are at a higher risk of complications. Besides biology, social factors like lack of support, access to healthcare, and mental health conditions also play a role in these discrepancies.
Given the multifaceted nature of AF, a personalized, multidisciplinary approach is required for effective management. By addressing each patient's unique risks, it is possible to reduce complications and improve outcomes for individuals with AF.
- The presence of chronic conditions like cardiovascular, respiratory, metabolic, and mental health disorders increases the risk of atrial fibrillation (AF), a common form of arrhythmia.
- Dr. Stephen Tang, a cardiac electrophysiologist, emphasizes that treating AF extends beyond medication or ablation, as the disease is driven by numerous risk factors and comorbidities.
- If uncontrolled, AF can continue to recur even after ablation procedures, so identifying and addressing these contributing factors is essential for long-term AF management.
- Regular physical activity is associated with a lower risk of AF, while a sedentary lifestyle increases the risk, and at least 150 minutes of moderate-to-vigorous exercise a week is recommended to lower the risk.
- Chronic cardiovascular, respiratory, and mental health conditions are risk factors and complications for AF. For instance, obstructive sleep apnea can increase the risk of AF and recurrence after catheter ablation.
- Management and treatment of comorbid cardiovascular conditions such as hypertension can help reduce the risk of AF complications. However, the use of anticoagulants may need careful consideration in patients undergoing surgery for coronary artery disease due to the risk of bleeding complications.
- Besides biology, social factors like lack of support, access to healthcare, and mental health conditions also play a role in the risk of AF, with studies suggesting that individuals of South Asian and African origin may have a lower risk of AF than the white population. Additionally, the risk of AF is higher in men than women, but women are at a higher risk of complications.
