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Clinical Care and Modifications for Atrial Fibrillation

Atrial fibrillation, also referred to as AFib or AF, is the most common type of arrhythmia, characterized by an irregular heartbeat in the atria which reduces flow to the heart ventricles. AF may lead to blood clots, stroke or other heart complications, as well as increased mortality. It is estimated that 2.7 to 6.1 million adults in the US have AF, and that number is expected to increase as the aging population grows.1

AF is not only associated with serious health concerns, but also results in significant associated healthcare costs and utilization, with an estimated $6 billion burden for the US annually.1 Over the past few decades, there have been research advances to help understand the complexities of AF, however, the subsequent advances in technology (e.g. catheter ablation technology) have not significantly impacted outcomes of AF for patients. Therefore, refocusing on preventative strategies that reduce the risk of AF development and progression AF are important.2

A recent article in the peer reviewed journal, Circulation,2 highlights the contributions of key AF risk factors and supports lifestyle changes and other noninvasive therapy options for risk factor modification AF.  Major modifiable risk factors include hypertension (estimated to account for up to 22% of AF cases3), obesity, diabetes, chronic kidney disease, heart failure, and heavy alcohol use.1 Currently recognized pillars of AF care include rate control, rhythm control and anticoagulation therapy.2 Building upon that model, the authors present an integrated care approach that incorporates risk factor modification as a fourth pillar of AF clinical care to help combat AF. 

Why is this Clinically Relevant? 

  • Atrial fibrillation is more common in older adults, so an aging population will continue to contribute to an increase in the incidence of AF
  • Preventative noninvasive therapeutic strategies targeting lifestyle changes and modifiable risk factors including weight loss, reduction in blood pressure and exercise should be considered as part of patient management plans by clinicians
  • A four-part integrated care model for AF that includes risk factor modification prevention should be considered


Link to abstract 


  1. Division for Heart Disease and Stroke Prevention. Centers for Disease Control and Prevention. Published August 22, 2017. Accessed September 29, 2017.
  2. Lau DH, Nattel S, Kalman JM, et al.. Modifiable risk factors and atrial fibrillation. Circulation. 2017;136(6):583-596..
  3. Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics-2015 update: a report from the American Heart Association. Circulation. 2015;131:e29-e322.

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