Feature Article

Risk factor management in atrial fibrillation. A key pillar of care

Feature Article

Risk factor management in atrial fibrillation. A key pillar of care

JOHN L. FITZGERALD, CELINE GALLAGHER, MELISSA E. MIDDELDORP, Prashanthan Sanders

Figures

© adamkaz/istockphoto.com model used for illustrative purposes only
© adamkaz/istockphoto.com model used for illustrative purposes only

Abstract

The role of intensive cardiovascular risk factor management is being increasingly recognised in atrial fibrillation guidelines. GPs play a critical role in supporting patients to optimise their cardiovascular risk factor profiles to reduce the rapidly growing burden of this condition.

Key Points

  • Crucial pillars of care for atrial fibrillation (AF) include risk factor modification, anticoagulation, rate control and rhythm control.
  • Randomised controlled trials and cohort studies show the benefit of risk factor modification in patients with AF, irrespective of treatment strategy, to reduce recurrence and burden of AF.
  • Key modifiable risk factors include a high body mass index, physical inactivity, alcohol use, tobacco use, hypertension, dyslipidaemia and obstructive sleep apnoea.
  • Risk factor modification for patients with AF is most effective when carried out in a structured clinic with multidisciplinary involvement and should be carefully tailored to the individual patient.
  • Risk factor modification should encompass patient-centred care, lifestyle journals, stepwise goal setting, flexible follow-up schedules, close surveillance of medications and other treatments, and comprehensive management of all modifiable risk factors.