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Risk Factor Management in Atrial Fibrillation: How to Deliver a Successful Clinic

  • Arrhythmias (J. Bunch, Section Editor)
  • Published:
Current Cardiovascular Risk Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

To summarize the evidence underpinning the role of risk factor management in atrial fibrillation (AF) and to describe the key components critical to the successful delivery of this aspect of AF care.

Recent Findings

Recent studies exploring the role of risk factor management in AF have demonstrated the importance of comprehensively and simultaneously managing all risk factors. Strong evidence exists to support the aggressive management of overweight and obesity, hypertension, diabetes, obstructive sleep apnea, alcohol excess, and physical inactivity in improving outcomes in this population. Other factors, such as dyslipidemia, are managed according to individual cardiovascular risk. The use of protocol-driven care, assisted by a checklist, is critical to ensure that all risk factors are comprehensively addressed in a standardized fashion. Engaging the patient through the health behavior change process, by assessing importance and confidence in achieving the desired change and goal setting to achieve targets, increases the likelihood of success. Regular reviews and feedback are essential to ensure accountability and ongoing engagement.

Summary

Risk factor management is an essential pillar of AF care that should be incorporated alongside appropriate use of oral anticoagulation, rate control, and rhythm management. Successful implementation of this aspect of comprehensive AF management requires a protocol-driven approach with regular follow-up to maximize patient engagement.

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Authors and Affiliations

  1. Centre for Heart Rhythm Disorders, Department of Cardiology, Royal Adelaide Hospital, University of Adelaide, Port Road, Adelaide, SA, 5000, Australia

    Celine Gallagher, John L Fitzgerald, Michael B Stokes, Jean Jacques Noubiap, Adrian D Elliott, Jeroen M Hendriks, Melissa E Middeldorp, Prashanthan Sanders & Dennis H Lau

  2. Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia

    Jeroen M Hendriks

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  1. Celine Gallagher
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  2. John L Fitzgerald
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CG and DHL conceived and designed the manuscript. All authors critically revised the manuscript for important content.

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Correspondence to Dennis H Lau.

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Conflict of Interest

Dr. Hendriks reports that the University of Adelaide has received on his behalf lecture and/or consulting fees from Medtronic and Pfizer/BMS. Dr. Sanders reports having served on the advisory board of Medtronic, Abbott Medical, Boston-Scientific, Pacemate, and CathRx. Dr. Sanders reports that the University of Adelaide has received on his behalf lecture and/or consulting fees from Medtronic, Boston-Scientific, and Abbott Medical. Dr. Sanders reports that the University of Adelaide has received on his behalf research funding from Medtronic, Abbott Medical, Boston Scientific, and Microport CRM. Dr. Lau reports that the University of Adelaide has received on his behalf lecture and/or consulting fees from Abbott Medical, Bayer, Biotronik, BMS Pfizer, Boehringer Ingelheim, Medtronic, and MicroPort CRM. All other authors have nothing to disclose.

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Gallagher, C., Fitzgerald, J.L., Stokes, M.B. et al. Risk Factor Management in Atrial Fibrillation: How to Deliver a Successful Clinic. Curr Cardiovasc Risk Rep 15, 9 (2021). https://doi.org/10.1007/s12170-021-00671-x

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