Please use this identifier to cite or link to this item: https://hdl.handle.net/2440/124891
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Type: Journal article
Title: Lifestyle modifications for treatment of atrial fibrillation
Author: Middeldorp, M.E.
Ariyaratnam, J.
Lau, D.
Sanders, P.
Citation: Heart, 2020; 106(5):325-332
Publisher: BMJ Publishing Group
Issue Date: 2020
ISSN: 1355-6037
1468-201X
Statement of
Responsibility: 
Melissa E Middeldorp, Jonathan Ariyaratnam, Dennis Lau, Prashanthan Sanders
Abstract: The management of atrial fibrillation (AF) has focused on anticoagulation, rhythm control and ventricular rate control. Recently, a fourth pillar of AF management has been incorporated recognising the importance of risk factor management (RFM). There are several risk factors that contribute to the development and progression of AF, these include traditional risk factors such as age, hypertension, heart failure, diabetes and valvular heart disease. However, increasingly it is recognised that obesity, sleep apnoea, hyperlipidaemia, smoking, alcohol, physical inactivity, genetics, aortic stiffness are associated with the development of AF. Importantly, several of these risk factors are modifiable. We have seen the evolution of RFM programmes which have demonstrated promising results. Indeed, the evidence is now so compelling that major clinical guidelines strongly advocate that aggressive treatment of these risk factors as a key component of AF management. Patients with AF who comprehensively managed their risk factors demonstrate greater reduction in symptoms, AF burden, more successful ablations and improved outcomes with greater AF freedom. In this article, we will review the evidence for the association between cardiac risk factors and AF and assess the burgeoning evidence for improved AF outcomes associated with aggressive cardiac RFM.
Keywords: Humans
Atrial Fibrillation
Risk Factors
Practice Guidelines as Topic
Healthy Lifestyle
Rights: © Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.
DOI: 10.1136/heartjnl-2019-315327
Grant ID: NHMRC
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