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Prevention of Atrial Fibrillation

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ASPC Manual of Preventive Cardiology

Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

Worldwide population aging leads to increased incidence and prevalence of many chronic diseases including atrial fibrillation (AF). This multifactorial arrhythmia has complex interrelationships with cardiovascular disease and shares with them classical risk factors. Becoming a global epidemic, AF-targeted prevention programs are necessary but largely missing. There is an unmet epidemiological and clinical need to start prevention at early ages and at the population level to prevent AF. The main strategies to address primordial and primary prevention of AF are physical activity and control of weight, blood pressure, and diabetes. We summarize current knowledge in AF epidemiology and discuss disease trends and preventive opportunities offered by managing underlying risk factors and concomitant disorders.

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Abbreviations

AA:

African Americans

AF:

Atrial fibrillation

ARIC :

Atherosclerosis Risk in Communities Studies

BMI:

Body mass index

BP:

Blood pressure

CKD:

Chronic kidney disease

CPAP:

Continuous positive airway pressure

CVD:

Cardiovascular disease

DM :

Diabetes mellitus

FHS:

Framingham Heart Study

HF:

Heart failure

HFpEF :

HF with preserved ejection fraction

LA:

Left atrial

LV:

Left ventricular

MI:

Myocardial infarction

OSA:

Obstructive sleep apnea

PA:

Physical activity

RAS :

Renin-angiotensin axis

TGF :

Transforming growth factor

VTE:

Venous thromboembolism

References

  1. Chugh SS, Havmoeller R, Narayanan K, Singh D, Rienstra M, Benjamin EJ, Gillum RF, Kim YH, McAnulty JH Jr, Zheng ZJ, Forouzanfar MH, Naghavi M, Mensah GA, Ezzati M, Murray CJ. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation. 2014;129:837–47.

    Article  PubMed  Google Scholar 

  2. Schnabel RB, Yin X, Gona P, Larson MG, Beiser AS, McManus DD, Newton-Cheh C, Lubitz SA, Magnani JW, Ellinor PT, Seshadri S, Wolf PA, Vasan RS, Benjamin EJ, Levy D. 50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study. Lancet. 2015;386:154–62.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Magnussen C, Niiranen TJ, Ojeda FM, Gianfagna F, Blankenberg S, Njolstad I, Vartiainen E, Sans S, Pasterkamp G, Hughes M, Costanzo S, Donati MB, Jousilahti P, Linneberg A, Palosaari T, et al. Sex differences and similarities in atrial fibrillation epidemiology, risk factors, and mortality in community cohorts: results from the BiomarCaRE Consortium (Biomarker for Cardiovascular Risk Assessment in Europe). Circulation. 2017;136:1588–97.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Braunwald E. Shattuck lecture – cardiovascular medicine at the turn of the millennium: triumphs, concerns, and opportunities. N Engl J Med. 1997;337:1360–9.

    Article  CAS  PubMed  Google Scholar 

  5. Borne RT, O’Donnell C, Turakhia MP, Varosy PD, Jackevicius CA, Marzec LN, Masoudi FA, Hess PL, Maddox TM, Ho PM. Adherence and outcomes to direct oral anticoagulants among patients with atrial fibrillation: findings from the veterans health administration. BMC Cardiovasc Disord. 2017;17:236.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Gupta A, Perera T, Ganesan A, Sullivan T, Lau DH, Roberts-Thomson KC, Brooks AG, Sanders P. Complications of catheter ablation of atrial fibrillation: a systematic review. Circ Arrhythm Electrophysiol. 2013;6:1082–8.

    Article  PubMed  Google Scholar 

  7. Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, Singer DE. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001;285:2370–5.

    Article  CAS  PubMed  Google Scholar 

  8. Miyasaka Y, Barnes ME, Gersh BJ, Cha SS, Bailey KR, Abhayaratna WP, Seward JB, Tsang TS. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation. 2006;114:119–25.

    Article  PubMed  Google Scholar 

  9. Colilla S, Crow A, Petkun W, Singer DE, Simon T, Liu X. Estimates of current and future incidence and prevalence of atrial fibrillation in the U.S. adult population. Am J Cardiol. 2013;112:1142–7.

    Article  PubMed  Google Scholar 

  10. Krijthe BP, Kunst A, Benjamin EJ, Lip GY, Franco OH, Hofman A, Witteman JC, Stricker BH, Heeringa J. Projections on the number of individuals with atrial fibrillation in the European Union, from 2000 to 2060. Eur Heart J. 2013;34:2746–51.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Lip GYH, Brechin CM, Lane DA. The global burden of atrial fibrillation and stroke: a systematic review of the epidemiology of atrial fibrillation in regions outside North America and Europe. Chest. 2012;142:1489–98.

    Article  PubMed  Google Scholar 

  12. Jacobs MS, van Hulst M, Adeoye AM, Tieleman RG, Postma MJ, Owolabi MO. Atrial fibrillation in Africa-An under-reported and unrecognized risk factor for stroke: a systematic review. Glob Heart. 2019;14:269–79.

    Article  PubMed  Google Scholar 

  13. Chiang CE, Wang KL, Lip GY. Stroke prevention in atrial fibrillation: an Asian perspective. Thromb Haemost. 2014;111:789–97.

    Article  CAS  PubMed  Google Scholar 

  14. Lloyd-Jones DM, Wang TJ, Leip EP, Larson MG, Levy D, Vasan RS, D’Agostino RB, Massaro JM, Beiser A, Wolf PA, Benjamin EJ. Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation. 2004;110:1042–6.

    Article  PubMed  Google Scholar 

  15. Heeringa J, van der Kuip DA, Hofman A, Kors JA, van Herpen G, Stricker BH, Stijnen T, Lip GY, Witteman JC. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J. 2006;27:949–53.

    Article  PubMed  Google Scholar 

  16. Mou L, Norby FL, Chen LY, O’Neal WT, Lewis TT, Loehr LR, Soliman EZ, Alonso A. Lifetime risk of atrial fibrillation by race and socioeconomic status: ARIC study (Atherosclerosis Risk in Communities). Circ Arrhythm Electrophysiol. 2018;11:e006350.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Virani SS, Alonso A, Benjamin EJ, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, Khan SS, et al. Heart disease and stroke statistics-2020 update: a report from the American Heart Association. Circulation. 2020;141(9):e139–596. CIR.0000000000000757.

    Article  PubMed  Google Scholar 

  18. Jackson SL, Tong X, Yin X, George MG, Ritchey MD. Emergency department, hospital inpatient, and mortality burden of atrial fibrillation in the United States, 2006 to 2014. Am J Cardiol. 2017;120:1966–73.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Weng LC, Preis SR, Hulme OL, Larson MG, Choi SH, Wang B, Trinquart L, McManus DD, Staerk L, Lin H, Lunetta KL, Ellinor PT, Benjamin EJ, Lubitz SA. Genetic predisposition, clinical risk factor burden, and lifetime risk of atrial fibrillation. Circulation. 2018;137:1027–38.

    Article  PubMed  Google Scholar 

  20. Staerk L, Wang B, Preis SR, Larson MG, Lubitz SA, Ellinor PT, McManus DD, Ko D, Weng LC, Lunetta KL, Frost L, Benjamin EJ, Trinquart L. Lifetime risk of atrial fibrillation according to optimal, borderline, or elevated levels of risk factors: cohort study based on longitudinal data from the Framingham Heart Study. BMJ. 2018;361:k1453.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Savelieva I, Camm AJ. Clinical relevance of silent atrial fibrillation: prevalence, prognosis, quality of life, and management. J Interv Card Electrophysiol. 2000;4:369–82.

    Article  CAS  PubMed  Google Scholar 

  22. Turakhia MP, Shafrin J, Bognar K, Trocio J, Abdulsattar Y, Wiederkehr D, Goldman DP. Estimated prevalence of undiagnosed atrial fibrillation in the United States. PLoS One. 2018;13:e0195088.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  23. Freedman B, Camm J, Calkins H, Healey JS, Rosenqvist M, Wang J, Albert CM, Anderson CS, Antoniou S, Benjamin EJ, Boriani G, Brachmann J, Brandes A, Chao TF, Conen D, et al. Screening for atrial fibrillation: a report of the AF-SCREEN International Collaboration. Circulation. 2017;135:1851–67.

    Article  PubMed  Google Scholar 

  24. Perez MV, Mahaffey KW, Hedlin H, Rumsfeld JS, Garcia A, Ferris T, Balasubramanian V, Russo AM, Rajmane A, Cheung L, Hung G, Lee J, Kowey P, Talati N, Nag D, et al. Large-scale assessment of a smartwatch to identify atrial fibrillation. N Engl J Med. 2019;381:1909–17.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Odutayo A, Wong CX, Hsiao AJ, Hopewell S, Altman DG, Emdin CA. Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: systematic review and meta-analysis. BMJ. 2016;354:i4482.

    Article  PubMed  Google Scholar 

  26. Soliman EZ, Safford MM, Muntner P, Khodneva Y, Dawood FZ, Zakai NA, Thacker EL, Judd S, Howard VJ, Howard G, Herrington DM, Cushman M. Atrial fibrillation and the risk of myocardial infarction. JAMA Intern Med. 2014;174:107–14.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991;22:983–8.

    Article  CAS  PubMed  Google Scholar 

  28. Frost L, Engholm G, Johnsen S, Moller H, Henneberg EW, Husted S. Incident thromboembolism in the aorta and the renal, mesenteric, pelvic, and extremity arteries after discharge from the hospital with a diagnosis of atrial fibrillation. Arch Intern Med. 2001;161:272–6.

    Article  CAS  PubMed  Google Scholar 

  29. Wang CC, Lin CL, Wang GJ, Chang CT, Sung FC, Kao CH. Atrial fibrillation associated with increased risk of venous thromboembolism. A population-based cohort study. Thromb Haemost. 2015;113:185–92.

    Article  PubMed  Google Scholar 

  30. Santangeli P, Di Biase L, Bai R, Mohanty S, Pump A, Cereceda Brantes M, Horton R, Burkhardt JD, Lakkireddy D, Reddy YM, Casella M, Dello Russo A, Tondo C, Natale A. Atrial fibrillation and the risk of incident dementia: a meta-analysis. Heart Rhythm. 2012;9:1761–8.

    Article  PubMed  Google Scholar 

  31. Kwok CS, Loke YK, Hale R, Potter JF, Myint PK. Atrial fibrillation and incidence of dementia: a systematic review and meta-analysis. Neurology. 2011;76:914–22.

    Article  CAS  PubMed  Google Scholar 

  32. Zhang L, Gallagher R, Neubeck L. Health-related quality of life in atrial fibrillation patients over 65 years: a review. Eur J Prev Cardiol. 2015;22:987–1002.

    Article  PubMed  Google Scholar 

  33. Benjamin EJ, Wolf PA, D’Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998;98:946–52.

    Article  CAS  PubMed  Google Scholar 

  34. Delaney JA, Yin X, Fontes JD, Wallace ER, Skinner A, Wang N, Hammill BG, Benjamin EJ, Curtis LH, Heckbert SR. Hospital and clinical care costs associated with atrial fibrillation for Medicare beneficiaries in the Cardiovascular Health Study and the Framingham Heart Study. SAGE Open Med. 2018;6:2050312118759444.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Johnsen SP, Dalby LW, Tackstrom T, Olsen J, Fraschke A. Cost of illness of atrial fibrillation: a nationwide study of societal impact. BMC Health Serv Res. 2017;17:714.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Heidenreich PA, Trogdon JG, Khavjou OA, Butler J, Dracup K, Ezekowitz MD, Finkelstein EA, Hong Y, Johnston SC, Khera A, Lloyd-Jones DM, Nelson SA, Nichol G, Orenstein D, Wilson PW, et al. Forecasting the future of cardiovascular disease in the United States: a policy statement from the American Heart Association. Circulation. 2011;123:933–44.

    Article  PubMed  Google Scholar 

  37. Schnabel RB, Lunetta KL, Larson MG, Dupuis J, Lipinska I, Rong J, Chen MH, Zhao Z, Yamamoto JF, Meigs JB, Nicaud V, Perret C, Zeller T, Blankenberg S, Tiret L, et al. The relation of genetic and environmental factors to systemic inflammatory biomarker concentrations. Circ Cardiovasc Genet. 2009;2:229–37.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Shen MJ, Arora R, Jalife J. Atrial Myopathy. JACC Basic Transl Sci. 2019;4:640–54.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Ko D, Rahman F, Schnabel RB, Yin X, Benjamin EJ, Christophersen IE. Atrial fibrillation in women: epidemiology, pathophysiology, presentation, and prognosis. Nat Rev Cardiol. 2016;13:321–32.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Chao TF, Liu CJ, Tuan TC, Chen TJ, Hsieh MH, Lip GYH, Chen SA. Lifetime risks, projected numbers, and adverse outcomes in Asian patients with atrial fibrillation: a report from the Taiwan Nationwide AF Cohort Study. Chest. 2018;153:453–66.

    Article  PubMed  Google Scholar 

  41. Guo Y, Tian Y, Wang H, Si Q, Wang Y, Lip GYH. Prevalence, incidence, and lifetime risk of atrial fibrillation in China: new insights into the global burden of atrial fibrillation. Chest. 2015;147:109–19.

    Article  PubMed  Google Scholar 

  42. Chien K-L, Su T-C, Hsu H-C, Chang W-T, Chen P-C, Chen M-F, Lee Y-T. Atrial fibrillation prevalence, incidence and risk of stroke and all-cause death among Chinese. Int J Cardiol. 2010;139:173–80.

    Article  PubMed  Google Scholar 

  43. Alonso A, Krijthe BP, Aspelund T, Stepas KA, Pencina MJ, Moser CB, Sinner MF, Sotoodehnia N, Fontes JD, Janssens AC, Kronmal RA, Magnani JW, Witteman JC, Chamberlain AM, Lubitz SA, et al. Simple risk model predicts incidence of atrial fibrillation in a racially and geographically diverse population: the CHARGE-AF consortium. J Am Heart Assoc. 2013;2:e000102.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Benjamin EJ, Levy D, Vaziri SM, D’Agostino RB, Belanger AJ, Wolf PA. Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA. 1994;271:840–4.

    Article  CAS  PubMed  Google Scholar 

  45. Borzecki AM, Bridgers DK, Liebschutz JM, Kader B, Kazis LE, Berlowitz DR. Racial differences in the prevalence of atrial fibrillation among males. J Natl Med Assoc. 2008;100:237–45.

    PubMed  Google Scholar 

  46. Rodriguez CJ, Soliman EZ, Alonso A, Swett K, Okin PM, Goff DC Jr, Heckbert SR. Atrial fibrillation incidence and risk factors in relation to race-ethnicity and the population attributable fraction of atrial fibrillation risk factors: the Multi-Ethnic Study of Atherosclerosis. Ann Epidemiol. 2015;25:71–6, 76 e1.

    Article  PubMed  Google Scholar 

  47. Waks JW, Passman RS, Matos J, Reynolds M, Thosani A, Mela T, Pederson D, Glotzer TV, Zimetbaum P. Intermittent anticoagulation guided by continuous atrial fibrillation burden monitoring using dual-chamber pacemakers and implantable cardioverter-defibrillators: results from the Tailored Anticoagulation for Non-Continuous Atrial Fibrillation (TACTIC-AF) pilot study. Heart Rhythm. 2018;15:1601–7.

    Article  PubMed  Google Scholar 

  48. Soliman EZ, Alonso A, Goff DC Jr. Atrial fibrillation and ethnicity: the known, the unknown and the paradox. Futur Cardiol. 2009;5:547–56.

    Article  Google Scholar 

  49. Kamel H, Kleindorfer DO, Bhave PD, Cushman M, Levitan EB, Howard G, Soliman EZ. Rates of atrial fibrillation in black versus white patients with pacemakers. J Am Heart Assoc. 2016;5:e002492.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Lau CP, Gbadebo TD, Connolly SJ, Van Gelder IC, Capucci A, Gold MR, Israel CW, Morillo CA, Siu CW, Abe H, Carlson M, Tse HF, Hohnloser SH, Healey JS, Investigators A. Ethnic differences in atrial fibrillation identified using implanted cardiac devices. J Cardiovasc Electrophysiol. 2013;24:381–7.

    Article  PubMed  Google Scholar 

  51. Heckbert SR, Austin TR, Jensen PN, Chen LY, Post WS, Floyd JS, Soliman EZ, Kronmal RA, Psaty BM. Differences by race/ethnicity in the prevalence of clinically detected and monitor-detected atrial fibrillation: MESA. Circ Arrhythm Electrophysiol. 2020;13:e007698.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Marcus GM, Olgin JE, Whooley M, Vittinghoff E, Stone KL, Mehra R, Hulley SB, Schiller NB. Racial differences in atrial fibrillation prevalence and left atrial size. Am J Med. 2010;123:375 e1–7.

    Article  Google Scholar 

  53. Roberts JD, Hu D, Heckbert SR, Alonso A, Dewland TA, Vittinghoff E, Liu Y, Psaty BM, Olgin JE, Magnani JW, Huntsman S, Burchard EG, Arking DE, Bibbins-Domingo K, Harris TB, et al. Genetic investigation into the differential risk of atrial fibrillation among black and white individuals. JAMA Cardiol. 2016;1:442–50.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Marcus GM, Alonso A, Peralta CA, Lettre G, Vittinghoff E, Lubitz SA, Fox ER, Levitzky YS, Mehra R, Kerr KF, Deo R, Sotoodehnia N, Akylbekova M, Ellinor PT, Paltoo DN, et al. European ancestry as a risk factor for atrial fibrillation in African Americans. Circulation. 2010;122:2009–15.

    Article  PubMed  PubMed Central  Google Scholar 

  55. Conway DS, Lip GY. Ethnicity in relation to atrial fibrillation and stroke (the West Birmingham Stroke Project). Am J Cardiol. 2003;92:1476–9.

    Article  PubMed  Google Scholar 

  56. Finucane MM, Stevens GA, Cowan MJ, Danaei G, Lin JK, Paciorek CJ, Singh GM, Gutierrez HR, Lu Y, Bahalim AN, Farzadfar F, Riley LM, Ezzati M. National, regional, and global trends in body-mass index since 1980: systematic analysis of health examination surveys and epidemiological studies with 960 country-years and 9.1 million participants. Lancet. 2011;377:557–67.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Hruby A, Hu FB. The epidemiology of obesity: a big picture. PharmacoEconomics. 2015;33:673–89.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Global BMIMC, Di Angelantonio E, Bhupathiraju Sh N, Wormser D, Gao P, Kaptoge S, Berrington de Gonzalez A, Cairns BJ, Huxley R, Jackson Ch L, Joshy G, Lewington S, Manson JE, Murphy N, Patel AV, et al. Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet. 2016;388:776–86.

    Article  Google Scholar 

  59. Aune D, Sen A, Schlesinger S, Norat T, Janszky I, Romundstad P, Tonstad S, Riboli E, Vatten LJ. Body mass index, abdominal fatness, fat mass and the risk of atrial fibrillation: a systematic review and dose-response meta-analysis of prospective studies. Eur J Epidemiol. 2017;32:181–92.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Feng T, Vegard M, Strand LB, Laugsand LE, Morkedal B, Aune D, Vatten L, Ellekjaer H, Loennechen JP, Mukamal K, Janszky I. Metabolically healthy obesity and risk for atrial fibrillation: the HUNT Study. Obesity (Silver Spring). 2019;27:332–8.

    Article  CAS  Google Scholar 

  61. Wang TJ, Parise H, Levy D, D’Agostino RB Sr, Wolf PA, Vasan RS, Benjamin EJ. Obesity and the risk of new-onset atrial fibrillation. JAMA. 2004;292:2471–7.

    Article  CAS  PubMed  Google Scholar 

  62. Gami AS, Hodge DO, Herges RM, Olson EJ, Nykodym J, Kara T, Somers VK. Obstructive sleep apnea, obesity, and the risk of incident atrial fibrillation. J Am Coll Cardiol. 2007;49:565–71.

    Article  PubMed  Google Scholar 

  63. Rosengren A, Hauptman PJ, Lappas G, Olsson L, Wilhelmsen L, Swedberg K. Big men and atrial fibrillation: effects of body size and weight gain on risk of atrial fibrillation in men. Eur Heart J. 2009;30:1113–20.

    Article  PubMed  Google Scholar 

  64. Tedrow UB, Conen D, Ridker PM, Cook NR, Koplan BA, Manson JE, Buring JE, Albert CM. The long- and short-term impact of elevated body mass index on the risk of new atrial fibrillation the WHS (women’s health study). J Am Coll Cardiol. 2010;55:2319–27.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Huxley RR, Misialek JR, Agarwal SK, Loehr LR, Soliman EZ, Chen LY, Alonso A. Physical activity, obesity, weight change, and risk of atrial fibrillation: the Atherosclerosis Risk in Communities study. Circ Arrhythm Electrophysiol. 2014;7:620–5.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Chatterjee NA, Giulianini F, Geelhoed B, Lunetta KL, Misialek JR, Niemeijer MN, Rienstra M, Rose LM, Smith AV, Arking DE, Ellinor PT, Heeringa J, Lin H, Lubitz SA, Soliman EZ, et al. Genetic obesity and the risk of atrial fibrillation: causal estimates from Mendelian randomization. Circulation. 2017;135:741–54.

    Article  PubMed  Google Scholar 

  67. Hall JE, do Carmo JM, da Silva AA, Wang Z, Hall ME. Obesity-induced hypertension: interaction of neurohumoral and renal mechanisms. Circ Res. 2015;116:991–1006.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  68. Lazar MA. How obesity causes diabetes: not a tall tale. Science. 2005;307:373–5.

    Article  CAS  PubMed  Google Scholar 

  69. Despres JP, Lemieux I. Abdominal obesity and metabolic syndrome. Nature. 2006;444:881–7.

    Article  CAS  PubMed  Google Scholar 

  70. Janszky I, Romundstad P, Laugsand LE, Vatten LJ, Mukamal KJ, Morkedal B. Weight and weight change and risk of acute myocardial infarction and heart failure – the HUNT Study. J Intern Med. 2016;280:312–22.

    Article  CAS  PubMed  Google Scholar 

  71. Goudis CA, Korantzopoulos P, Ntalas IV, Kallergis EM, Ketikoglou DG. Obesity and atrial fibrillation: a comprehensive review of the pathophysiological mechanisms and links. J Cardiol. 2015;66:361–9.

    Article  PubMed  Google Scholar 

  72. Abed HS, Samuel CS, Lau DH, Kelly DJ, Royce SG, Alasady M, Mahajan R, Kuklik P, Zhang Y, Brooks AG, Nelson AJ, Worthley SG, Abhayaratna WP, Kalman JM, Wittert GA, et al. Obesity results in progressive atrial structural and electrical remodeling: implications for atrial fibrillation. Heart Rhythm. 2013;10:90–100.

    Article  PubMed  Google Scholar 

  73. Gerdts E, Wachtell K, Omvik P, Otterstad JE, Oikarinen L, Boman K, Dahlof B, Devereux RB. Left atrial size and risk of major cardiovascular events during antihypertensive treatment: losartan intervention for endpoint reduction in hypertension trial. Hypertension. 2007;49:311–6.

    Article  CAS  PubMed  Google Scholar 

  74. Iacobellis G, Ribaudo MC, Leto G, Zappaterreno A, Vecci E, Di Mario U, Leonetti F. Influence of excess fat on cardiac morphology and function: study in uncomplicated obesity. Obes Res. 2002;10:767–73.

    Article  PubMed  Google Scholar 

  75. Engeli S, Sharma AM. The renin-angiotensin system and natriuretic peptides in obesity-associated hypertension. J Mol Med (Berl). 2001;79:21–9.

    Article  CAS  Google Scholar 

  76. Bahceci M, Gokalp D, Bahceci S, Tuzcu A, Atmaca S, Arikan S. The correlation between adiposity and adiponectin, tumor necrosis factor alpha, interleukin-6 and high sensitivity C-reactive protein levels. Is adipocyte size associated with inflammation in adults? J Endocrinol Investig. 2007;30:210–4.

    Article  CAS  Google Scholar 

  77. Rabkin SW. The relationship between epicardial fat and indices of obesity and the metabolic syndrome: a systematic review and meta-analysis. Metab Syndr Relat Disord. 2014;12:31–42.

    Article  CAS  PubMed  Google Scholar 

  78. Lin YK, Chen YC, Chang SL, Lin YJ, Chen JH, Yeh YH, Chen SA, Chen YJ. Heart failure epicardial fat increases atrial arrhythmogenesis. Int J Cardiol. 2013;167:1979–83.

    Article  PubMed  Google Scholar 

  79. Vincent HK, Powers SK, Stewart DJ, Shanely RA, Demirel H, Naito H. Obesity is associated with increased myocardial oxidative stress. Int J Obes Relat Metab Disord. 1999;23:67–74.

    Article  CAS  PubMed  Google Scholar 

  80. Zhou YT, Grayburn P, Karim A, Shimabukuro M, Higa M, Baetens D, Orci L, Unger RH. Lipotoxic heart disease in obese rats: implications for human obesity. Proc Natl Acad Sci U S A. 2000;97:1784–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  81. Fenger-Grøn M, Vinter N, Frost L. Body mass and atrial fibrillation risk: status of the epidemiology concerning the influence of fat versus lean body mass. Trends Cardiovasc Med. 2020;30(4):205–11. S1050-1738(19)30074-X.

    Article  PubMed  Google Scholar 

  82. Pedersen BK, Febbraio MA. Muscles, exercise and obesity: skeletal muscle as a secretory organ. Nat Rev Endocrinol. 2012;8:457–65.

    Article  CAS  PubMed  Google Scholar 

  83. Pedersen BK, Steensberg A, Fischer C, Keller C, Keller P, Plomgaard P, Febbraio M, Saltin B. Searching for the exercise factor: is IL-6 a candidate? J Muscle Res Cell Motil. 2003;24:113–9.

    Article  CAS  PubMed  Google Scholar 

  84. Matsui T, Li L, Wu JC, Cook SA, Nagoshi T, Picard MH, Liao R, Rosenzweig A. Phenotypic spectrum caused by transgenic overexpression of activated Akt in the heart. J Biol Chem. 2002;277:22896–901.

    Article  CAS  PubMed  Google Scholar 

  85. Schwingshackl L, Morze J, Hoffmann G. Mediterranean diet and health status: active ingredients and pharmacological mechanisms. Br J Pharmacol. 2020;177:1241–57.

    Article  CAS  PubMed  Google Scholar 

  86. Martinez-Gonzalez MA, Bes-Rastrollo M. Dietary patterns, Mediterranean diet, and cardiovascular disease. Curr Opin Lipidol. 2014;25:20–6.

    Article  CAS  PubMed  Google Scholar 

  87. Casas R, Sacanella E, Urpi-Sarda M, Chiva-Blanch G, Ros E, Martinez-Gonzalez MA, Covas MI, Salas-Salvado J, Fiol M, Aros F, Estruch R. The effects of the mediterranean diet on biomarkers of vascular wall inflammation and plaque vulnerability in subjects with high risk for cardiovascular disease. A randomized trial. PLoS One. 2014;9:e100084.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  88. Martinez-Gonzalez MA, Toledo E, Aros F, Fiol M, Corella D, Salas-Salvado J, Ros E, Covas MI, Fernandez-Crehuet J, Lapetra J, Munoz MA, Fito M, Serra-Majem L, Pinto X, Lamuela-Raventos RM, et al. Extravirgin olive oil consumption reduces risk of atrial fibrillation: the PREDIMED (Prevencion con Dieta Mediterranea) trial. Circulation. 2014;130:18–26.

    Article  CAS  PubMed  Google Scholar 

  89. Bazal P, Gea A, de la Fuente-Arrillaga C, Barrio-Lopez MT, Martinez-Gonzalez MA, Ruiz-Canela M. Olive oil intake and risk of atrial fibrillation in the SUN cohort. Nutr Metab Cardiovasc Dis. 2019;29:450–7.

    Article  CAS  PubMed  Google Scholar 

  90. Mattioli AV, Miloro C, Pennella S, Pedrazzi P, Farinetti A. Adherence to Mediterranean diet and intake of antioxidants influence spontaneous conversion of atrial fibrillation. Nutr Metab Cardiovasc Dis. 2013;23:115–21.

    Article  CAS  PubMed  Google Scholar 

  91. Blum S, Aeschbacher S, Meyre P, Zwimpfer L, Reichlin T, Beer JH, Ammann P, Auricchio A, Kobza R, Erne P, Moschovitis G, Di Valentino M, Shah D, Schlapfer J, Henz S, et al. Incidence and predictors of atrial fibrillation progression. J Am Heart Assoc. 2019;8:e012554.

    Article  PubMed  PubMed Central  Google Scholar 

  92. Azarbal F, Stefanick ML, Salmoirago-Blotcher E, Manson JE, Albert CM, LaMonte MJ, Larson JC, Li W, Martin LW, Nassir R, Garcia L, Assimes TL, Tharp KM, Hlatky MA, Perez MV. Obesity, physical activity, and their interaction in incident atrial fibrillation in postmenopausal women. J Am Heart Assoc. 2014;3:e001127.

    Article  PubMed  PubMed Central  Google Scholar 

  93. Physical Activity Guidelines Advisory Committee report, 2008. To the Secretary of Health and Human Services. Part A: executive summary. Nutr Rev. 2009;67:114–20.

    Google Scholar 

  94. Morseth B, Graff-Iversen S, Jacobsen BK, Jorgensen L, Nyrnes A, Thelle DS, Vestergaard P, Lochen ML. Physical activity, resting heart rate, and atrial fibrillation: the Tromso Study. Eur Heart J. 2016;37:2307–13.

    Article  PubMed  PubMed Central  Google Scholar 

  95. Drca N, Wolk A, Jensen-Urstad M, Larsson SC. Atrial fibrillation is associated with different levels of physical activity levels at different ages in men. Heart. 2014;100:1037–42.

    Article  PubMed  Google Scholar 

  96. Bassuk SS, Manson JE. Epidemiological evidence for the role of physical activity in reducing risk of type 2 diabetes and cardiovascular disease. J Appl Physiol (1985). 2005;99:1193–204.

    Article  Google Scholar 

  97. Milani RV, Lavie CJ, Mehra MR. Reduction in C-reactive protein through cardiac rehabilitation and exercise training. J Am Coll Cardiol. 2004;43:1056–61.

    Article  CAS  PubMed  Google Scholar 

  98. Everett BM, Conen D, Buring JE, Moorthy MV, Lee IM, Albert CM. Physical activity and the risk of incident atrial fibrillation in women. Circ Cardiovasc Qual Outcomes. 2011;4:321–7.

    Article  PubMed  PubMed Central  Google Scholar 

  99. Mozaffarian D, Furberg CD, Psaty BM, Siscovick D. Physical activity and incidence of atrial fibrillation in older adults: the cardiovascular health study. Circulation. 2008;118:800–7.

    Article  PubMed  PubMed Central  Google Scholar 

  100. Aizer A, Gaziano JM, Cook NR, Manson JE, Buring JE, Albert CM. Relation of vigorous exercise to risk of atrial fibrillation. Am J Cardiol. 2009;103:1572–7.

    Article  PubMed  PubMed Central  Google Scholar 

  101. Ricci C, Gervasi F, Gaeta M, Smuts CM, Schutte AE, Leitzmann MF. Physical activity volume in relation to risk of atrial fibrillation. A non-linear meta-regression analysis. Eur J Prev Cardiol. 2018;25:857–66.

    Article  PubMed  Google Scholar 

  102. Abdulla J, Nielsen JR. Is the risk of atrial fibrillation higher in athletes than in the general population? A systematic review and meta-analysis. Europace. 2009;11:1156–9.

    Article  PubMed  Google Scholar 

  103. Wilhelm M. Atrial fibrillation in endurance athletes. Eur J Prev Cardiol. 2014;21:1040–8.

    Article  PubMed  Google Scholar 

  104. Guasch E, Benito B, Qi X, Cifelli C, Naud P, Shi Y, Mighiu A, Tardif JC, Tadevosyan A, Chen Y, Gillis MA, Iwasaki YK, Dobrev D, Mont L, Heximer S, et al. Atrial fibrillation promotion by endurance exercise: demonstration and mechanistic exploration in an animal model. J Am Coll Cardiol. 2013;62:68–77.

    Article  PubMed  Google Scholar 

  105. Ravelli F, Allessie M. Effects of atrial dilatation on refractory period and vulnerability to atrial fibrillation in the isolated Langendorff-perfused rabbit heart. Circulation. 1997;96:1686–95.

    Article  CAS  PubMed  Google Scholar 

  106. Engelmann MD, Svendsen JH. Inflammation in the genesis and perpetuation of atrial fibrillation. Eur Heart J. 2005;26:2083–92.

    Article  CAS  PubMed  Google Scholar 

  107. Psychari SN, Apostolou TS, Sinos L, Hamodraka E, Liakos G, Kremastinos DT. Relation of elevated C-reactive protein and interleukin-6 levels to left atrial size and duration of episodes in patients with atrial fibrillation. Am J Cardiol. 2005;95:764–7.

    Article  CAS  PubMed  Google Scholar 

  108. Smith LL. Cytokine hypothesis of overtraining: a physiological adaptation to excessive stress? Med Sci Sports Exerc. 2000;32:317–31.

    Article  CAS  PubMed  Google Scholar 

  109. Benjamin EJ, Muntner P, Alonso A, Bittencourt MS, Callaway CW, Carson AP, Chamberlain AM, Chang AR, Cheng S, Das SR, Delling FN, Djousse L, Elkind MSV, Ferguson JF, Fornage M, et al. Heart disease and stroke statistics-2019 update: a report from the American Heart Association. Circulation. 2019;139:e56–e528.

    Article  PubMed  Google Scholar 

  110. Dixit S, Pletcher MJ, Vittinghoff E, Imburgia K, Maguire C, Whitman IR, Glantz SA, Olgin JE, Marcus GM. Secondhand smoke and atrial fibrillation: data from the Health eHeart Study. Heart Rhythm. 2016;13:3–9.

    Article  PubMed  Google Scholar 

  111. Aune D, Schlesinger S, Norat T, Riboli E. Tobacco smoking and the risk of atrial fibrillation: a systematic review and meta-analysis of prospective studies. Eur J Prev Cardiol. 2018. https://doi.org/10.1177/2047487318780435.

  112. Shan H, Zhang Y, Lu Y, Zhang Y, Pan Z, Cai B, Wang N, Li X, Feng T, Hong Y, Yang B. Downregulation of miR-133 and miR-590 contributes to nicotine-induced atrial remodelling in canines. Cardiovasc Res. 2009;83:465–72.

    Article  CAS  PubMed  Google Scholar 

  113. Wang H, Shi H, Zhang L, Pourrier M, Yang B, Nattel S, Wang Z. Nicotine is a potent blocker of the cardiac A-type K(+) channels. Effects on cloned Kv4.3 channels and native transient outward current. Circulation. 2000;102:1165–71.

    Article  CAS  PubMed  Google Scholar 

  114. DeFilippis EM, Singh A, Divakaran S, Gupta A, Collins BL, Biery D, Qamar A, Fatima A, Ramsis M, Pipilas D, Rajabi R, Eng M, Hainer J, Klein J, Januzzi JL, et al. Cocaine and marijuana use among young adults with myocardial infarction. J Am Coll Cardiol. 2018;71:2540–51.

    Article  PubMed  PubMed Central  Google Scholar 

  115. Levitzky YS, Guo CY, Rong J, Larson MG, Walter RE, Keaney JF Jr, Sutherland PA, Vasan A, Lipinska I, Evans JC, Benjamin EJ. Relation of smoking status to a panel of inflammatory markers: the framingham offspring. Atherosclerosis. 2008;201:217–24.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  116. Alzahrani T, Pena I, Temesgen N, Glantz SA. Association between electronic cigarette use and myocardial infarction. Am J Prev Med. 2018;55:455–61.

    Article  PubMed  PubMed Central  Google Scholar 

  117. Lichtenstein AH, Appel LJ, Brands M, Carnethon M, Daniels S, Franch HA, Franklin B, Kris-Etherton P, Harris WS, Howard B, Karanja N, Lefevre M, Rudel L, Sacks F, Van Horn L, et al. Diet and lifestyle recommendations revision 2006: a scientific statement from the American Heart Association Nutrition Committee. Circulation. 2006;114:82–96.

    Article  PubMed  Google Scholar 

  118. Larsson SC, Drca N, Wolk A. Alcohol consumption and risk of atrial fibrillation: a prospective study and dose-response meta-analysis. J Am Coll Cardiol. 2014;64:281–9.

    Article  CAS  PubMed  Google Scholar 

  119. Dixit S, Alonso A, Vittinghoff E, Soliman EZ, Chen LY, Marcus GM. Past alcohol consumption and incident atrial fibrillation: the Atherosclerosis Risk in Communities (ARIC) Study. PLoS One. 2017;12:e0185228.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  120. Gallagher C, Hendriks JML, Elliott AD, Wong CX, Rangnekar G, Middeldorp ME, Mahajan R, Lau DH, Sanders P. Alcohol and incident atrial fibrillation - a systematic review and meta-analysis. Int J Cardiol. 2017;246:46–52.

    Article  PubMed  Google Scholar 

  121. Voskoboinik A, Kalman JM, De Silva A, Nicholls T, Costello B, Nanayakkara S, Prabhu S, Stub D, Azzopardi S, Vizi D, Wong G, Nalliah C, Sugumar H, Wong M, Kotschet E, et al. Alcohol abstinence in drinkers with atrial fibrillation. N Engl J Med. 2020;382:20–8.

    Article  PubMed  Google Scholar 

  122. Kanny D, Naimi TS, Liu Y, Lu H, Brewer RD. Annual total binge drinks consumed by U.S. adults, 2015. Am J Prev Med. 2018;54:486–96.

    Article  PubMed  PubMed Central  Google Scholar 

  123. Pasek M, Bebarova M, Christe G, Simurdova M, Simurda J. Acute effects of ethanol on action potential and intracellular Ca(2+) transient in cardiac ventricular cells: a simulation study. Med Biol Eng Comput. 2016;54:753–62.

    Article  PubMed  Google Scholar 

  124. Gould L, Reddy CV, Becker W, Oh KC, Kim SG. Electrophysiologic properties of alcohol in man. J Electrocardiol. 1978;11:219–26.

    Article  CAS  PubMed  Google Scholar 

  125. McManus DD, Yin X, Gladstone R, Vittinghoff E, Vasan RS, Larson MG, Benjamin EJ, Marcus GM. Alcohol consumption, left atrial diameter, and atrial fibrillation. J Am Heart Assoc. 2016;5:e004060.

    Article  PubMed  PubMed Central  Google Scholar 

  126. Voskoboinik A, Prabhu S, Ling LH, Kalman JM, Kistler PM. Alcohol and atrial fibrillation: a Sobering review. J Am Coll Cardiol. 2016;68:2567–76.

    Article  CAS  PubMed  Google Scholar 

  127. Sareen J. Posttraumatic stress disorder in adults: impact, comorbidity, risk factors, and treatment. Can J Psychiatr. 2014;59:460–7.

    Article  Google Scholar 

  128. Rosman L, Lampert R, Ramsey CM, Dziura J, Chui PW, Brandt C, Haskell S, Burg MM. Posttraumatic stress disorder and risk for early incident atrial fibrillation: a prospective cohort study of 1.1 million young adults. J Am Heart Assoc. 2019;8:e013741.

    Article  PubMed  PubMed Central  Google Scholar 

  129. Mattioli AV, Bonatti S, Zennaro M, Melotti R, Mattioli G. Effect of coffee consumption, lifestyle and acute life stress in the development of acute lone atrial fibrillation. J Cardiovasc Med (Hagerstown). 2008;9:794–8.

    Article  Google Scholar 

  130. Eaker ED, Sullivan LM, Kelly-Hayes M, D’Agostino RB Sr, Benjamin EJ. Anger and hostility predict the development of atrial fibrillation in men in the Framingham Offspring Study. Circulation. 2004;109:1267–71.

    Article  PubMed  Google Scholar 

  131. Kivimaki M, Nyberg ST, Batty GD, Kawachi I, Jokela M, Alfredsson L, Bjorner JB, Borritz M, Burr H, Dragano N, Fransson EI, Heikkila K, Knutsson A, Koskenvuo M, Kumari M, et al. Long working hours as a risk factor for atrial fibrillation: a multi-cohort study. Eur Heart J. 2017;38:2621–8.

    Article  PubMed  PubMed Central  Google Scholar 

  132. Garg PK, Claxton JS, Soliman EZ, Chen LY, Lewis TT, Mosley T, Jr., Alonso A. Associations of anger, vital exhaustion, anti-depressant use, and poor social ties with incident atrial fibrillation: the Atherosclerosis Risk in Communities Study. Eur J Prev Cardiol. 2020:2047487319897163.

    Google Scholar 

  133. Taggart P, Boyett MR, Logantha S, Lambiase PD. Anger, emotion, and arrhythmias: from brain to heart. Front Physiol. 2011;2:67.

    Article  PubMed  PubMed Central  Google Scholar 

  134. Lampert R. Behavioral influences on cardiac arrhythmias. Trends Cardiovasc Med. 2016;26:68–77.

    Article  PubMed  Google Scholar 

  135. Spragg D. Left atrial fibrosis: role in atrial fibrillation pathophysiology and treatment outcomes. J Atr Fibrillation. 2013;5:810.

    PubMed  PubMed Central  Google Scholar 

  136. Aviles RJ, Martin DO, Apperson-Hansen C, Houghtaling PL, Rautaharju P, Kronmal RA, Tracy RP, Van Wagoner DR, Psaty BM, Lauer MS, Chung MK. Inflammation as a risk factor for atrial fibrillation. Circulation. 2003;108:3006–10.

    Article  PubMed  Google Scholar 

  137. Christensen MA, Dixit S, Dewland TA, Whitman IR, Nah G, Vittinghoff E, Mukamal KJ, Redline S, Robbins JA, Newman AB, Patel SR, Magnani JW, Psaty BM, Olgin JE, Pletcher MJ, et al. Sleep characteristics that predict atrial fibrillation. Heart Rhythm. 2018;15:1289–95.

    Article  PubMed  PubMed Central  Google Scholar 

  138. Marulanda-Londono E, Chaturvedi S. The interplay between obstructive sleep apnea and atrial fibrillation. Front Neurol. 2017;8:668.

    Article  PubMed  PubMed Central  Google Scholar 

  139. Spiegel K, Leproult R, Van Cauter E. Impact of sleep debt on metabolic and endocrine function. Lancet. 1999;354:1435–9.

    Article  CAS  PubMed  Google Scholar 

  140. Bernardi L, Sleight P, Bandinelli G, Cencetti S, Fattorini L, Wdowczyc-Szulc J, Lagi A. Effect of rosary prayer and yoga mantras on autonomic cardiovascular rhythms: comparative study. BMJ. 2001;323:1446–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  141. Lakkireddy D, Atkins D, Pillarisetti J, Ryschon K, Bommana S, Drisko J, Vanga S, Dawn B. Effect of yoga on arrhythmia burden, anxiety, depression, and quality of life in paroxysmal atrial fibrillation: the YOGA My Heart Study. J Am Coll Cardiol. 2013;61:1177–82.

    Article  PubMed  Google Scholar 

  142. Berkman LF, Syme SL. Social networks, host resistance, and mortality: a nine-year follow-up study of Alameda County residents. Am J Epidemiol. 1979;109:186–204.

    Article  CAS  PubMed  Google Scholar 

  143. Holt-Lunstad J, Smith TB, Layton JB. Social relationships and mortality risk: a meta-analytic review. PLoS Med. 2010;7:e1000316.

    Article  PubMed  PubMed Central  Google Scholar 

  144. Pantell M, Rehkopf D, Jutte D, Syme SL, Balmes J, Adler N. Social isolation: a predictor of mortality comparable to traditional clinical risk factors. Am J Public Health. 2013;103:2056–62.

    Article  PubMed  PubMed Central  Google Scholar 

  145. Laugesen K, Baggesen LM, Schmidt SAJ, Glymour MM, Lasgaard M, Milstein A, Sorensen HT, Adler NE, Ehrenstein V. Social isolation and all-cause mortality: a population-based cohort study in Denmark. Sci Rep. 2018;8:4731.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  146. Kaplan GA, Keil JE. Socioeconomic factors and cardiovascular disease: a review of the literature. Circulation. 1993;88:1973–98.

    Article  CAS  PubMed  Google Scholar 

  147. Misialek JR, Rose KM, Everson-Rose SA, Soliman EZ, Clark CJ, Lopez FL, Alonso A. Socioeconomic status and the incidence of atrial fibrillation in whites and blacks: the Atherosclerosis Risk in Communities (ARIC) study. J Am Heart Assoc. 2014;3:e001159.

    Article  PubMed  PubMed Central  Google Scholar 

  148. Zöller B, Li X, Sundquist J, Sundquist K. Neighbourhood deprivation and hospitalization for atrial fibrillation in Sweden. Europace. 2013;15:1119–27.

    Article  PubMed  Google Scholar 

  149. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jones DW, Materson BJ, Oparil S, Wright JT, Roccella EJ. Seventh report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. Hypertension. 2003;42:1206–52.

    Article  CAS  PubMed  Google Scholar 

  150. Thomas SJ, Booth JN, Dai C, Li X, Allen N, Calhoun D, Carson AP, Gidding S, Lewis CE, Shikany JM, Shimbo D, Sidney S, Muntner P. Cumulative incidence of hypertension by 55 years of age in blacks and whites: the CARDIA Study. J Am Heart Assoc. 2018;7:e007988.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  151. Chen V, Ning H, Allen N, Kershaw K, Khan S, Lloyd-Jones DM, Wilkins JT. Lifetime risks for hypertension by contemporary guidelines in African American and white men and women. JAMA Cardiol. 2019;4:455–9.

    Article  PubMed  PubMed Central  Google Scholar 

  152. Kim YG, Han KD, Choi JI, Yung Boo K, Kim DY, Oh SK, Lee KN, Shim J, Kim JS, Kim YH. Impact of the duration and degree of hypertension and body weight on new-onset atrial fibrillation: a Nationwide Population-Based Study. Hypertension. 2019;74:e45–51.

    Article  CAS  PubMed  Google Scholar 

  153. Psaty BM, Manolio TA, Kuller LH, Kronmal RA, Cushman M, Fried LP, White R, Furberg CD, Rautaharju PM. Incidence of and risk factors for atrial fibrillation in older adults. Circulation. 1997;96:2455–61.

    Article  CAS  PubMed  Google Scholar 

  154. Huxley RR, Lopez FL, Folsom AR, Agarwal SK, Loehr LR, Soliman EZ, Maclehose R, Konety S, Alonso A. Absolute and attributable risks of atrial fibrillation in relation to optimal and borderline risk factors: the Atherosclerosis Risk in Communities (ARIC) study. Circulation. 2011;123:1501–8.

    Article  PubMed  PubMed Central  Google Scholar 

  155. Mitchell GF, Vasan RS, Keyes MJ, Parise H, Wang TJ, Larson MG, D’Agostino RB Sr, Kannel WB, Levy D, Benjamin EJ. Pulse pressure and risk of new-onset atrial fibrillation. JAMA. 2007;297:709–15.

    Article  CAS  PubMed  Google Scholar 

  156. Dzeshka MS, Lip GY, Snezhitskiy V, Shantsila E. Cardiac fibrosis in patients with atrial fibrillation: mechanisms and clinical implications. J Am Coll Cardiol. 2015;66:943–59.

    Article  PubMed  Google Scholar 

  157. Rodríguez-Vita J, Sánchez-López E, Esteban V, Rupérez M, Egido J, Ruiz-Ortega M. Angiotensin II activates the Smad pathway in vascular smooth muscle cells by a transforming growth factor-beta-independent mechanism. Circulation. 2005;111:2509–17.

    Article  PubMed  CAS  Google Scholar 

  158. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, Castella M, Diener HC, Heidbuchel H, Hendriks J, Hindricks G, Manolis AS, Oldgren J, Popescu BA, Schotten U, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37:2893–962.

    Article  PubMed  Google Scholar 

  159. January CT, Wann LS, Calkins H, Chen LY, Cigarroa JE, Cleveland JC Jr, Ellinor PT, Ezekowitz MD, Field ME, Furie KL, Heidenreich PA, Murray KT, Shea JB, Tracy CM, Yancy CW. 2019 AHA/ACC/HRS focused update of the 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines and the Heart Rhythm Society in Collaboration with the Society of Thoracic Surgeons. Circulation. 2019;140:e125–51.

    Article  PubMed  Google Scholar 

  160. Emdin CA, Callender T, Cao J, Rahimi K. Effect of antihypertensive agents on risk of atrial fibrillation: a meta-analysis of large-scale randomized trials. Europace. 2015;17:701–10.

    Article  PubMed  Google Scholar 

  161. Rutter MK, Parise H, Benjamin EJ, Levy D, Larson MG, Meigs JB, Nesto RW, Wilson PW, Vasan RS. Impact of glucose intolerance and insulin resistance on cardiac structure and function: sex-related differences in the Framingham Heart Study. Circulation. 2003;107:448–54.

    Article  CAS  PubMed  Google Scholar 

  162. Watanabe H, Tanabe N, Watanabe T, Darbar D, Roden DM, Sasaki S, Aizawa Y. Metabolic syndrome and risk of development of atrial fibrillation: the Niigata preventive medicine study. Circulation. 2008;117:1255–60.

    Article  PubMed  PubMed Central  Google Scholar 

  163. Huxley RR, Filion KB, Konety S, Alonso A. Meta-analysis of cohort and case-control studies of type 2 diabetes mellitus and risk of atrial fibrillation. Am J Cardiol. 2011;108:56–62.

    Article  PubMed  PubMed Central  Google Scholar 

  164. Zhang X, Zhang Z, Zhao Y, Jiang N, Qiu J, Yang Y, Li J, Liang X, Wang X, Tse G, Li G, Liu T. Alogliptin, a dipeptidyl peptidase-4 Inhibitor, alleviates atrial remodeling and improves mitochondrial function and biogenesis in diabetic rabbits. J Am Heart Assoc. 2017;6:e005945.

    Article  PubMed  PubMed Central  Google Scholar 

  165. Odegaard AO, Jacobs DR Jr, Sanchez OA, Goff DC Jr, Reiner AP, Gross MD. Oxidative stress, inflammation, endothelial dysfunction and incidence of type 2 diabetes. Cardiovasc Diabetol. 2016;15:51.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  166. Karam BS, Chavez-Moreno A, Koh W, Akar JG, Akar FG. Oxidative stress and inflammation as central mediators of atrial fibrillation in obesity and diabetes. Cardiovasc Diabetol. 2017;16:120.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  167. Goudis CA, Korantzopoulos P, Ntalas IV, Kallergis EM, Liu T, Ketikoglou DG. Diabetes mellitus and atrial fibrillation: pathophysiological mechanisms and potential upstream therapies. Int J Cardiol. 2015;184:617–22.

    Article  PubMed  Google Scholar 

  168. Qi W, Zhang N, Korantzopoulos P, Letsas KP, Cheng M, Di F, Tse G, Liu T, Li G. Serum glycated hemoglobin level as a predictor of atrial fibrillation: a systematic review with meta-analysis and meta-regression. PLoS One. 2017;12:e0170955.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  169. Zhang Q, Liu T, Ng CY, Li G. Diabetes mellitus and atrial remodeling: mechanisms and potential upstream therapies. Cardiovasc Ther. 2014;32:233–41.

    Article  CAS  PubMed  Google Scholar 

  170. Watson NF, Badr MS, Belenky G, Bliwise DL, Buxton OM, Buysse D, Dinges DF, Gangwisch J, Grandner MA, Kushida C, Malhotra RK, Martin JL, Patel SR, Quan SF, Tasali E. Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Sleep. 2015;38:843–4.

    PubMed  PubMed Central  Google Scholar 

  171. Yin J, Jin X, Shan Z, Li S, Huang H, Li P, Peng X, Peng Z, Yu K, Bao W, Yang W, Chen X, Liu L. Relationship of sleep duration with all-cause mortality and cardiovascular events: a systematic review and dose-response meta-analysis of prospective cohort studies. J Am Heart Assoc. 2017;6:e005947.

    Article  PubMed  PubMed Central  Google Scholar 

  172. Wang Q, Xi B, Liu M, Zhang Y, Fu M. Short sleep duration is associated with hypertension risk among adults: a systematic review and meta-analysis. Hypertens Res. 2012;35:1012–8.

    Article  PubMed  Google Scholar 

  173. Genuardi MV, Ogilvie RP, Saand AR, DeSensi RS, Saul MI, Magnani JW, Patel SR. Association of short sleep duration and atrial fibrillation. Chest. 2019;156(3):544–52.

    Article  PubMed  PubMed Central  Google Scholar 

  174. Heinzer R, Vat S, Marques-Vidal P, Marti-Soler H, Andries D, Tobback N, Mooser V, Preisig M, Malhotra A, Waeber G, Vollenweider P, Tafti M, Haba-Rubio J. Prevalence of sleep-disordered breathing in the general population: the HypnoLaus study. Lancet Respir Med. 2015;3:310–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  175. Costa LE, Uchoa CH, Harmon RR, Bortolotto LA, Lorenzi-Filho G, Drager LF. Potential underdiagnosis of obstructive sleep apnoea in the cardiology outpatient setting. Heart. 2015;101:1288–92.

    Article  CAS  PubMed  Google Scholar 

  176. Iwasaki YK, Kato T, Xiong F, Shi YF, Naud P, Maguy A, Mizuno K, Tardif JC, Comtois P, Nattel S. Atrial fibrillation promotion with long-term repetitive obstructive sleep apnea in a rat model. J Am Coll Cardiol. 2014;64:2013–23.

    Article  PubMed  Google Scholar 

  177. Walters TE, Lee G, Spence S, Larobina M, Atkinson V, Antippa P, Goldblatt J, O’Keefe M, Sanders P, Kistler PM, Kalman JM. Acute atrial stretch results in conduction slowing and complex signals at the pulmonary vein to left atrial junction: insights into the mechanism of pulmonary vein arrhythmogenesis. Circ Arrhythm Electrophysiol. 2014;7:1189–97.

    Article  PubMed  Google Scholar 

  178. Dimitri H, Ng M, Brooks AG, Kuklik P, Stiles MK, Lau DH, Antic N, Thornton A, Saint DA, McEvoy D, Antic R, Kalman JM, Sanders P. Atrial remodeling in obstructive sleep apnea: implications for atrial fibrillation. Heart Rhythm. 2012;9:321–7.

    Article  PubMed  Google Scholar 

  179. Kohler M, Stradling JR. Mechanisms of vascular damage in obstructive sleep apnea. Nat Rev Cardiol. 2010;7:677–85.

    Article  PubMed  Google Scholar 

  180. Mehra R, Stone KL, Varosy PD, Hoffman AR, Marcus GM, Blackwell T, Ibrahim OA, Salem R, Redline S. Nocturnal Arrhythmias across a spectrum of obstructive and central sleep-disordered breathing in older men: outcomes of sleep disorders in older men (MrOS sleep) study. Arch Intern Med. 2009;169:1147–55.

    Article  PubMed  PubMed Central  Google Scholar 

  181. Monahan K, Storfer-Isser A, Mehra R, Shahar E, Mittleman M, Rottman J, Punjabi N, Sanders M, Quan SF, Resnick H, Redline S. Triggering of nocturnal arrhythmias by sleep-disordered breathing events. J Am Coll Cardiol. 2009;54:1797–804.

    Article  PubMed  PubMed Central  Google Scholar 

  182. Linz D, Woehrle H, Bitter T, Fox H, Cowie MR, Bohm M, Oldenburg O. The importance of sleep-disordered breathing in cardiovascular disease. Clin Res Cardiol. 2015;104:705–18.

    Article  PubMed  Google Scholar 

  183. Matiello M, Nadal M, Tamborero D, Berruezo A, Montserrat J, Embid C, Rios J, Villacastin J, Brugada J, Mont L. Low efficacy of atrial fibrillation ablation in severe obstructive sleep apnoea patients. Europace. 2010;12:1084–9.

    Article  PubMed  Google Scholar 

  184. Yokoe T, Minoguchi K, Matsuo H, Oda N, Minoguchi H, Yoshino G, Hirano T, Adachi M. Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure. Circulation. 2003;107:1129–34.

    Article  CAS  PubMed  Google Scholar 

  185. Usui K, Bradley TD, Spaak J, Ryan CM, Kubo T, Kaneko Y, Floras JS. Inhibition of awake sympathetic nerve activity of heart failure patients with obstructive sleep apnea by nocturnal continuous positive airway pressure. J Am Coll Cardiol. 2005;45:2008–11.

    Article  PubMed  Google Scholar 

  186. Tkacova R, Rankin F, Fitzgerald FS, Floras JS, Bradley TD. Effects of continuous positive airway pressure on obstructive sleep apnea and left ventricular afterload in patients with heart failure. Circulation. 1998;98:2269–75.

    Article  CAS  PubMed  Google Scholar 

  187. Bansal N, Zelnick LR, Alonso A, Benjamin EJ, de Boer IH, Deo R, Katz R, Kestenbaum B, Mathew J, Robinson-Cohen C, Sarnak MJ, Shlipak MG, Sotoodehnia N, Young B, Heckbert SR. eGFR and Albuminuria in relation to risk of incident atrial fibrillation: a meta-analysis of the Jackson Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Cardiovascular Health Study. Clin J Am Soc Nephrol. 2017;12:1386–98.

    Article  PubMed  PubMed Central  Google Scholar 

  188. Watanabe H, Watanabe T, Sasaki S, Nagai K, Roden DM, Aizawa Y. Close bidirectional relationship between chronic kidney disease and atrial fibrillation: the Niigata preventive medicine study. Am Heart J. 2009;158:629–36.

    Article  PubMed  Google Scholar 

  189. Ehrlich JR, Hohnloser SH, Nattel S. Role of angiotensin system and effects of its inhibition in atrial fibrillation: clinical and experimental evidence. Eur Heart J. 2006;27:512–8.

    Article  CAS  PubMed  Google Scholar 

  190. Guo Y, Lip GY, Apostolakis S. Inflammation in atrial fibrillation. J Am Coll Cardiol. 2012;60:2263–70.

    Article  CAS  PubMed  Google Scholar 

  191. Massicotte-Azarniouch D, Kuwornu JP, Carrero JJ, Lam NN, Molnar AO, Zimmerman D, McCallum MK, Garg AX, Sood MM. Incident atrial fibrillation and the risk of congestive heart failure, myocardial infarction, end-stage kidney disease, and mortality among patients with a decreased estimated GFR. Am J Kidney Dis. 2018;71:191–9.

    Article  PubMed  Google Scholar 

  192. Vazquez E, Sanchez-Perales C, Lozano C, Garcia-Cortes MJ, Borrego F, Guzman M, Perez P, Pagola C, Borrego MJ, Perez V. Comparison of prognostic value of atrial fibrillation versus sinus rhythm in patients on long-term hemodialysis. Am J Cardiol. 2003;92:868–71.

    Article  PubMed  Google Scholar 

  193. Soliman EZ, Lopez F, O’Neal WT, Chen LY, Bengtson L, Zhang ZM, Loehr L, Cushman M, Alonso A. Atrial fibrillation and risk of ST-segment-elevation versus non-ST-segment-elevation myocardial infarction: the Atherosclerosis Risk in Communities (ARIC) Study. Circulation. 2015;131:1843–50.

    Article  PubMed  PubMed Central  Google Scholar 

  194. Laurent G, Zeller M, Dentan G, Moreau D, Laurent Y, Beer JC, Makki H, Lhuillier I, Janin-Manificat L, Fraison M, Cottin Y. Prognostic impact of new onset atrial fibrillation in acute non-ST elevation myocardial infarction data from the RICO survey. Heart. 2005;91:369–70.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  195. Jons C, Jacobsen UG, Joergensen RM, Olsen NT, Dixen U, Johannessen A, Huikuri H, Messier M, McNitt S, Thomsen PE. The incidence and prognostic significance of new-onset atrial fibrillation in patients with acute myocardial infarction and left ventricular systolic dysfunction: a CARISMA substudy. Heart Rhythm. 2011;8:342–8.

    Article  PubMed  Google Scholar 

  196. Gupta S, Vaidya SR, Arora S, Bahekar A, Devarapally SR. Type 2 versus type 1 myocardial infarction: a comparison of clinical characteristics and outcomes with a meta-analysis of observational studies. Cardiovasc Diagn Ther. 2017;7:348–58.

    Article  PubMed  PubMed Central  Google Scholar 

  197. Shibata T, Kawakami S, Noguchi T, Tanaka T, Asaumi Y, Kanaya T, Nagai T, Nakao K, Fujino M, Nagatsuka K, Ishibashi-Ueda H, Nishimura K, Miyamoto Y, Kusano K, Anzai T, et al. Prevalence, clinical features, and prognosis of acute myocardial infarction attributable to coronary artery embolism. Circulation. 2015;132:241–50.

    Article  CAS  PubMed  Google Scholar 

  198. Kornej J, Apostolakis S, Bollmann A, Lip GY. The emerging role of biomarkers in atrial fibrillation. Can J Cardiol. 2013;29:1181–93.

    Article  PubMed  Google Scholar 

  199. Rathore SS, Berger AK, Weinfurt KP, Schulman KA, Oetgen WJ, Gersh BJ, Solomon AJ. Acute myocardial infarction complicated by atrial fibrillation in the elderly: prevalence and outcomes. Circulation. 2000;101:969–74.

    Article  CAS  PubMed  Google Scholar 

  200. Alasady M, Shipp NJ, Brooks AG, Lim HS, Lau DH, Barlow D, Kuklik P, Worthley MI, Roberts-Thomson KC, Saint DA, Abhayaratna W, Sanders P. Myocardial infarction and atrial fibrillation: importance of atrial ischemia. Circ Arrhythm Electrophysiol. 2013;6:738–45.

    Article  CAS  PubMed  Google Scholar 

  201. Celik S, Erdol C, Baykan M, Kaplan S, Kasap H. Relation between paroxysmal atrial fibrillation and left ventricular diastolic function in patients with acute myocardial infarction. Am J Cardiol. 2001;88:160–2, a5.

    Article  CAS  PubMed  Google Scholar 

  202. Parashar S, Kella D, Reid KJ, Spertus JA, Tang F, Langberg J, Vaccarino V, Kontos MC, Lopes RD, Lloyd MS. New-onset atrial fibrillation after acute myocardial infarction and its relation to admission biomarkers (from the TRIUMPH registry). Am J Cardiol. 2013;112:1390–5.

    Article  PubMed  PubMed Central  Google Scholar 

  203. Nagahama Y, Sugiura T, Takehana K, Hatada K, Inada M, Iwasaka T. The role of infarction-associated pericarditis on the occurrence of atrial fibrillation. Eur Heart J. 1998;19:287–92.

    Article  CAS  PubMed  Google Scholar 

  204. Jabre P, Roger VL, Murad MH, Chamberlain AM, Prokop L, Adnet F, Jouven X. Mortality associated with atrial fibrillation in patients with myocardial infarction: a systematic review and meta-analysis. Circulation. 2011;123:1587–93.

    Article  PubMed  PubMed Central  Google Scholar 

  205. Berton G, Cordiano R, Cucchini F, Cavuto F, Pellegrinet M, Palatini P. Atrial fibrillation during acute myocardial infarction: association with all-cause mortality and sudden death after 7-year of follow-up. Int J Clin Pract. 2009;63:712–21.

    Article  CAS  PubMed  Google Scholar 

  206. Wang TJ, Larson MG, Levy D, Vasan RS, Leip EP, Wolf PA, D’Agostino RB, Murabito JM, Kannel WB, Benjamin EJ. Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study. Circulation. 2003;107:2920–5.

    Article  PubMed  Google Scholar 

  207. Santhanakrishnan R, Wang N, Larson MG, Magnani JW, McManus DD, Lubitz SA, Ellinor PT, Cheng S, Vasan RS, Lee DS, Wang TJ, Levy D, Benjamin EJ, Ho JE. Atrial fibrillation begets heart failure and vice versa: temporal associations and differences in preserved versus reduced ejection fraction. Circulation. 2016;133:484–92.

    Article  PubMed  PubMed Central  Google Scholar 

  208. Ho KK, Pinsky JL, Kannel WB, Levy D. The epidemiology of heart failure: the Framingham Study. J Am Coll Cardiol. 1993;22:6a–13a.

    Article  CAS  PubMed  Google Scholar 

  209. Poole-Wilson PA, Swedberg K, Cleland JG, Di Lenarda A, Hanrath P, Komajda M, Lubsen J, Lutiger B, Metra M, Remme WJ, Torp-Pedersen C, Scherhag A, Skene A. Comparison of carvedilol and metoprolol on clinical outcomes in patients with chronic heart failure in the Carvedilol Or Metoprolol European Trial (COMET): randomised controlled trial. Lancet. 2003;362:7–13.

    Article  CAS  PubMed  Google Scholar 

  210. Zafrir B, Lund LH, Laroche C, Ruschitzka F, Crespo-Leiro MG, Coats AJS, Anker SD, Filippatos G, Seferovic PM, Maggioni AP, De Mora MM, Polonski L, Silva-Cardoso J, Amir O. Prognostic implications of atrial fibrillation in heart failure with reduced, mid-range, and preserved ejection fraction: a report from 14 964 patients in the European Society of Cardiology Heart Failure Long-Term Registry. Eur Heart J. 2018;39:4277–84.

    Article  CAS  PubMed  Google Scholar 

  211. Sanders P, Morton JB, Davidson NC, Spence SJ, Vohra JK, Sparks PB, Kalman JM. Electrical remodeling of the atria in congestive heart failure: electrophysiological and electroanatomic mapping in humans. Circulation. 2003;108:1461–8.

    Article  PubMed  Google Scholar 

  212. Brouwers FP, de Boer RA, van der Harst P, Voors AA, Gansevoort RT, Bakker SJ, Hillege HL, van Veldhuisen DJ, van Gilst WH. Incidence and epidemiology of new onset heart failure with preserved vs. reduced ejection fraction in a community-based cohort: 11-year follow-up of PREVEND. Eur Heart J. 2013;34:1424–31.

    Article  CAS  PubMed  Google Scholar 

  213. Francis GS, Goldsmith SR, Levine TB, Olivari MT, Cohn JN. The neurohumoral axis in congestive heart failure. Ann Intern Med. 1984;101:370–7.

    Article  CAS  PubMed  Google Scholar 

  214. Raymond RJ, Lee AJ, Messineo FC, Manning WJ, Silverman DI. Cardiac performance early after cardioversion from atrial fibrillation. Am Heart J. 1998;136:435–42.

    Article  CAS  PubMed  Google Scholar 

  215. Viswanathan K, Daniak SM, Salomone K, Kiely T, Patel U, Converso K, Manning WJ, Silverman DI. Effect of cardioversion of atrial fibrillation on improvement in left ventricular performance. Am J Cardiol. 2001;88:439–41.

    Article  CAS  PubMed  Google Scholar 

  216. Kottkamp H. Fibrotic atrial cardiomyopathy: a specific disease/syndrome supplying substrates for atrial fibrillation, atrial tachycardia, sinus node disease, AV node disease, and thromboembolic complications. J Cardiovasc Electrophysiol. 2012;23:797–9.

    Article  PubMed  Google Scholar 

  217. Daccarett M, Badger TJ, Akoum N, Burgon NS, Mahnkopf C, Vergara G, Kholmovski E, McGann CJ, Parker D, Brachmann J, Macleod RS, Marrouche NF. Association of left atrial fibrosis detected by delayed-enhancement magnetic resonance imaging and the risk of stroke in patients with atrial fibrillation. J Am Coll Cardiol. 2011;57:831–8.

    Article  PubMed  PubMed Central  Google Scholar 

  218. Benjamin EJ, D’Agostino RB, Belanger AJ, Wolf PA, Levy D. Left atrial size and the risk of stroke and death. The Framingham Heart Study. Circulation. 1995;92:835–41.

    Article  CAS  PubMed  Google Scholar 

  219. Vanassche T, Lauw MN, Eikelboom JW, Healey JS, Hart RG, Alings M, Avezum A, Diaz R, Hohnloser SH, Lewis BS, Shestakovska O, Wang J, Connolly SJ. Risk of ischaemic stroke according to pattern of atrial fibrillation: analysis of 6563 aspirin-treated patients in ACTIVE-A and AVERROES. Eur Heart J. 2015;36:281–7a.

    Article  PubMed  Google Scholar 

  220. Steinberg BA, Hellkamp AS, Lokhnygina Y, Patel MR, Breithardt G, Hankey GJ, Becker RC, Singer DE, Halperin JL, Hacke W, Nessel CC, Berkowitz SD, Mahaffey KW, Fox KA, Califf RM, et al. Higher risk of death and stroke in patients with persistent vs. paroxysmal atrial fibrillation: results from the ROCKET-AF Trial. Eur Heart J. 2015;36:288–96.

    Article  PubMed  Google Scholar 

  221. Healey JS, Connolly SJ, Gold MR, Israel CW, Van Gelder IC, Capucci A, Lau CP, Fain E, Yang S, Bailleul C, Morillo CA, Carlson M, Themeles E, Kaufman ES, Hohnloser SH, et al. Subclinical atrial fibrillation and the risk of stroke. N Engl J Med. 2012;366:120–9.

    Article  CAS  PubMed  Google Scholar 

  222. Vingerhoets F, Bogousslavsky J, Regli F, Van Melle G. Atrial fibrillation after acute stroke. Stroke. 1993;24:26–30.

    Article  CAS  PubMed  Google Scholar 

  223. van Bree MD, Roos YB, van der Bilt IA, Wilde AA, Sprengers ME, de Gans K, Vergouwen MD. Prevalence and characterization of ECG abnormalities after intracerebral hemorrhage. Neurocrit Care. 2010;12:50–5.

    Article  PubMed  Google Scholar 

  224. Wang Y, Qian Y, Smerin D, Zhang S, Zhao Q, Xiong X. Newly detected atrial fibrillation after acute stroke: a narrative review of causes and implications. Cardiology. 2019;144:1–10.

    Article  Google Scholar 

  225. Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest. 2010;137:263–72.

    Article  PubMed  Google Scholar 

  226. Singer DE, Chang Y, Borowsky LH, Fang MC, Pomernacki NK, Udaltsova N, Reynolds K, Go AS. A new risk scheme to predict ischemic stroke and other thromboembolism in atrial fibrillation: the ATRIA study stroke risk score. J Am Heart Assoc. 2013;2:e000250.

    Article  PubMed  PubMed Central  Google Scholar 

  227. van den Ham HA, Klungel OH, Singer DE, Leufkens HG, van Staa TP. Comparative performance of ATRIA, CHADS2, and CHA2DS2-VASc risk scores predicting stroke in patients with atrial fibrillation: results from a National Primary Care Database. J Am Coll Cardiol. 2015;66:1851–9.

    Article  PubMed  Google Scholar 

  228. Yaranov DM, Smyrlis A, Usatii N, Butler A, Petrini JR, Mendez J, Warshofsky MK. Effect of obstructive sleep apnea on frequency of stroke in patients with atrial fibrillation. Am J Cardiol. 2015;115:461–5.

    Article  PubMed  Google Scholar 

  229. Piccini JP, Stevens SR, Chang Y, Singer DE, Lokhnygina Y, Go AS, Patel MR, Mahaffey KW, Halperin JL, Breithardt G, Hankey GJ, Hacke W, Becker RC, Nessel CC, Fox KA, et al. Renal dysfunction as a predictor of stroke and systemic embolism in patients with nonvalvular atrial fibrillation: validation of the R(2)CHADS(2) index in the ROCKET AF (Rivaroxaban Once-daily, oral, direct factor Xa inhibition Compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation) and ATRIA (AnTicoagulation and Risk factors In Atrial fibrillation) study cohorts. Circulation. 2013;127:224–32.

    Article  CAS  PubMed  Google Scholar 

  230. Fanola CL, Ruff CT, Murphy SA, Jin J, Duggal A, Babilonia NA, Sritara P, Mercuri MF, Kamphuisen PW, Antman EM, Braunwald E, Giugliano RP. Efficacy and safety of edoxaban in patients with active malignancy and atrial fibrillation: analysis of the ENGAGE AF - TIMI 48 trial. J Am Heart Assoc. 2018;7:e008987.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  231. Chen LY, Chung MK, Allen LA, Ezekowitz M, Furie KL, McCabe P, Noseworthy PA, Perez MV, Turakhia MP. Atrial fibrillation burden: moving beyond atrial fibrillation as a binary entity: a scientific statement from the American Heart Association. Circulation. 2018;137:e623–44.

    Article  PubMed  PubMed Central  Google Scholar 

  232. Boriani G, Glotzer TV, Santini M, West TM, De Melis M, Sepsi M, Gasparini M, Lewalter T, Camm JA, Singer DE. Device-detected atrial fibrillation and risk for stroke: an analysis of >10,000 patients from the SOS AF project (Stroke preventiOn Strategies based on Atrial Fibrillation information from implanted devices). Eur Heart J. 2014;35:508–16.

    Article  PubMed  Google Scholar 

  233. Turakhia MP, Ziegler PD, Schmitt SK, Chang Y, Fan J, Than CT, Keung EK, Singer DE. Atrial fibrillation burden and short-term risk of stroke: case-crossover analysis of continuously recorded heart rhythm from cardiac electronic implanted devices. Circ Arrhythm Electrophysiol. 2015;8:1040–7.

    Article  PubMed  Google Scholar 

  234. Lutsey PL, Norby FL, Alonso A, Cushman M, Chen LY, Michos ED, Folsom AR. Atrial fibrillation and venous thromboembolism: evidence of bidirectionality in the Atherosclerosis Risk in Communities Study. J Thromb Haemost. 2018;16:670–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  235. Kline JA, Steuerwald MT, Marchick MR, Hernandez-Nino J, Rose GA. Prospective evaluation of right ventricular function and functional status 6 months after acute submassive pulmonary embolism: frequency of persistent or subsequent elevation in estimated pulmonary artery pressure. Chest. 2009;136:1202–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  236. Yusuf S, Al-Saady N, Camm AJ. 5-hydroxytryptamine and atrial fibrillation: how significant is this piece in the puzzle? J Cardiovasc Electrophysiol. 2003;14:209–14.

    Article  PubMed  Google Scholar 

  237. Spronk HM, De Jong AM, Verheule S, De Boer HC, Maass AH, Lau DH, Rienstra M, van Hunnik A, Kuiper M, Lumeij S, Zeemering S, Linz D, Kamphuisen PW, Ten Cate H, Crijns HJ, et al. Hypercoagulability causes atrial fibrosis and promotes atrial fibrillation. Eur Heart J. 2017;38:38–50.

    Article  CAS  PubMed  Google Scholar 

  238. Enga KF, Rye-Holmboe I, Hald EM, Lochen ML, Mathiesen EB, Njolstad I, Wilsgaard T, Braekkan SK, Hansen JB. Atrial fibrillation and future risk of venous thromboembolism: the Tromso study. J Thromb Haemost. 2015;13:10–6.

    Article  CAS  PubMed  Google Scholar 

  239. Silverstein MD, Heit JA, Mohr DN, Petterson TM, O’Fallon WM, Melton LJ 3rd. Trends in the incidence of deep vein thrombosis and pulmonary embolism: a 25-year population-based study. Arch Intern Med. 1998;158:585–93.

    Article  CAS  PubMed  Google Scholar 

  240. Stein PD, Matta F, Goldman J. Obesity and pulmonary embolism: the mounting evidence of risk and the mortality paradox. Thromb Res. 2011;128:518–23.

    Article  CAS  PubMed  Google Scholar 

  241. Kuipers S, Klein Klouwenberg PM, Cremer OL. Incidence, risk factors and outcomes of new-onset atrial fibrillation in patients with sepsis: a systematic review. Crit Care. 2014;18:688.

    Article  PubMed  PubMed Central  Google Scholar 

  242. Lindhardsen J, Ahlehoff O, Gislason GH, Madsen OR, Olesen JB, Svendsen JH, Torp-Pedersen C, Hansen PR. Risk of atrial fibrillation and stroke in rheumatoid arthritis: Danish nationwide cohort study. BMJ. 2012;344:e1257.

    Article  PubMed  PubMed Central  Google Scholar 

  243. Barra SN, Paiva LV, Providencia R, Fernandes A, Leitao MA. Atrial fibrillation in acute pulmonary embolism: prognostic considerations. Emerg Med J. 2014;31:308–12.

    Article  PubMed  Google Scholar 

  244. Ng AC, Adikari D, Yuan D, Lau JK, Yong AS, Chow V, Kritharides L. The prevalence and incidence of atrial fibrillation in patients with acute pulmonary embolism. PLoS One. 2016;11:e0150448.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  245. Pathak RK, Middeldorp ME, Meredith M, Mehta AB, Mahajan R, Wong CX, Twomey D, Elliott AD, Kalman JM, Abhayaratna WP, Lau DH, Sanders P. Long-term effect of goal-directed weight management in an atrial fibrillation cohort: a Long-Term Follow-Up Study (LEGACY). J Am Coll Cardiol. 2015;65:2159–69.

    Article  PubMed  Google Scholar 

  246. Pathak RK, Middeldorp ME, Lau DH, Mehta AB, Mahajan R, Twomey D, Alasady M, Hanley L, Antic NA, McEvoy RD, Kalman JM, Abhayaratna WP, Sanders P. Aggressive risk factor reduction study for atrial fibrillation and implications for the outcome of ablation: the ARREST-AF cohort study. J Am Coll Cardiol. 2014;64:2222–31.

    Article  PubMed  Google Scholar 

  247. Pathak RK, Elliott A, Middeldorp ME, Meredith M, Mehta AB, Mahajan R, Hendriks JM, Twomey D, Kalman JM, Abhayaratna WP, Lau DH, Sanders P. Impact of CARDIOrespiratory FITness on arrhythmia recurrence in obese individuals with atrial fibrillation: the CARDIO-FIT study. J Am Coll Cardiol. 2015;66:985–96.

    Article  PubMed  Google Scholar 

  248. Abed HS, Wittert GA, Leong DP, Shirazi MG, Bahrami B, Middeldorp ME, Lorimer MF, Lau DH, Antic NA, Brooks AG, Abhayaratna WP, Kalman JM, Sanders P. Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: a randomized clinical trial. JAMA. 2013;310:2050–60.

    Article  CAS  PubMed  Google Scholar 

  249. Patel D, Mohanty P, Di Biase L, Shaheen M, Lewis WR, Quan K, Cummings JE, Wang P, Al-Ahmad A, Venkatraman P, Nashawati E, Lakkireddy D, Schweikert R, Horton R, Sanchez J, et al. Safety and efficacy of pulmonary vein antral isolation in patients with obstructive sleep apnea: the impact of continuous positive airway pressure. Circ Arrhythm Electrophysiol. 2010;3:445–51.

    Article  PubMed  Google Scholar 

  250. Fein AS, Shvilkin A, Shah D, Haffajee CI, Das S, Kumar K, Kramer DB, Zimetbaum PJ, Buxton AE, Josephson ME, Anter E. Treatment of obstructive sleep apnea reduces the risk of atrial fibrillation recurrence after catheter ablation. J Am Coll Cardiol. 2013;62:300–5.

    Article  PubMed  Google Scholar 

  251. Healey JS, Baranchuk A, Crystal E, Morillo CA, Garfinkle M, Yusuf S, Connolly SJ. Prevention of atrial fibrillation with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers: a meta-analysis. J Am Coll Cardiol. 2005;45:1832–9.

    Article  CAS  PubMed  Google Scholar 

  252. Rahimi K, Emberson J, McGale P, Majoni W, Merhi A, Asselbergs FW, Krane V, Macfarlane PW, Executive P. Effect of statins on atrial fibrillation: collaborative meta-analysis of published and unpublished evidence from randomised controlled trials. BMJ. 2011;342:d1250.

    Article  PubMed  CAS  Google Scholar 

  253. Tall AR, Rader DJ. Trials and tribulations of CETP inhibitors. Circ Res. 2018;122:106–12.

    Article  CAS  PubMed  Google Scholar 

  254. Fordyce CB, Roe MT, Ahmad T, Libby P, Borer JS, Hiatt WR, Bristow MR, Packer M, Wasserman SM, Braunstein N, Pitt B, DeMets DL, Cooper-Arnold K, Armstrong PW, Berkowitz SD, et al. Cardiovascular drug development: is it dead or just hibernating? J Am Coll Cardiol. 2015;65:1567–82.

    Article  PubMed  Google Scholar 

  255. Van Norman GA. Overcoming the declining trends in innovation and investment in cardiovascular therapeutics: beyond EROOM’s Law. JACC Basic Transl Sci. 2017;2:613–25.

    Article  PubMed  PubMed Central  Google Scholar 

  256. Schnabel RB, Sullivan LM, Levy D, Pencina MJ, Massaro JM, D’Agostino RB Sr, Newton-Cheh C, Yamamoto JF, Magnani JW, Tadros TM, Kannel WB, Wang TJ, Ellinor PT, Wolf PA, Vasan RS, et al. Development of a risk score for atrial fibrillation (Framingham Heart Study): a community-based cohort study. Lancet. 2009;373:739–45.

    Article  PubMed  PubMed Central  Google Scholar 

  257. Schnabel RB, Aspelund T, Li G, Sullivan LM, Suchy-Dicey A, Harris TB, Pencina MJ, D’Agostino RB Sr, Levy D, Kannel WB, Wang TJ, Kronmal RA, Wolf PA, Burke GL, Launer LJ, et al. Validation of an atrial fibrillation risk algorithm in whites and African Americans. Arch Intern Med. 2010;170:1909–17.

    Article  PubMed  PubMed Central  Google Scholar 

  258. Everett BM, Cook NR, Conen D, Chasman DI, Ridker PM, Albert CM. Novel genetic markers improve measures of atrial fibrillation risk prediction. Eur Heart J. 2013;34:2243–51.

    Article  PubMed  PubMed Central  Google Scholar 

  259. Benjamin EJ, Chen PS, Bild DE, Mascette AM, Albert CM, Alonso A, Calkins H, Connolly SJ, Curtis AB, Darbar D, Ellinor PT, Go AS, Goldschlager NF, Heckbert SR, Jalife J, et al. Prevention of atrial fibrillation: report from a national heart, lung, and blood institute workshop. Circulation. 2009;119:606–18.

    Article  PubMed  PubMed Central  Google Scholar 

  260. Estes NA 3rd, Sacco RL, Al-Khatib SM, Ellinor PT, Bezanson J, Alonso A, Antzelevitch C, Brockman RG, Chen PS, Chugh SS, Curtis AB, DiMarco JP, Ellenbogen KA, Epstein AE, Ezekowitz MD, et al. American Heart Association atrial fibrillation research summit: a conference report from the American Heart Association. Circulation. 2011;124:363–72.

    Article  PubMed  PubMed Central  Google Scholar 

  261. Van Wagoner DR, Piccini JP, Albert CM, Anderson ME, Benjamin EJ, Brundel B, Califf RM, Calkins H, Chen PS, Chiamvimonvat N, Darbar D, Eckhardt LL, Ellinor PT, Exner DV, Fogel RI, et al. Progress toward the prevention and treatment of atrial fibrillation: a summary of the Heart Rhythm Society Research Forum on the Treatment and Prevention of Atrial Fibrillation, Washington, DC, December 9-10, 2013. Heart Rhythm. 2015;12:e5–e29.

    Article  PubMed  Google Scholar 

  262. Gorenek Chair B, Pelliccia Co-Chair A, Benjamin EJ, Boriani G, Crijns HJ, Fogel RI, Van Gelder IC, Halle M, Kudaiberdieva G, Lane DA, Bjerregaard Larsen T, Lip GY, Lochen ML, Marin F, Niebauer J, et al. European Heart Rhythm Association (EHRA)/European Association of Cardiovascular Prevention and Rehabilitation (EACPR) position paper on how to prevent atrial fibrillation endorsed by the Heart Rhythm Society (HRS) and Asia Pacific Heart Rhythm Society (APHRS). Eur J Prev Cardiol. 2017;24:4–40.

    Article  Google Scholar 

  263. Ko D, Schnabel RB, Trinquart L, Benjamin EJ. The changing landscape of atrial fibrillation: time to target heart failure prevention. JACC Heart Fail. 2017;5:561–4.

    Article  PubMed  Google Scholar 

  264. Jamaly S, Carlsson L, Peltonen M, Jacobson P, Sjostrom L, Karason K. Bariatric surgery and the risk of new-onset atrial fibrillation in Swedish obese subjects. J Am Coll Cardiol. 2016;68:2497–504.

    Article  PubMed  PubMed Central  Google Scholar 

  265. Hess PL, Kim S, Piccini JP, Allen LA, Ansell JE, Chang P, Freeman JV, Gersh BJ, Kowey PR, Mahaffey KW, Thomas L, Peterson ED, Fonarow GC. Use of evidence-based cardiac prevention therapy among outpatients with atrial fibrillation. Am J Med. 2013;126:625–32.e1.

    Article  PubMed  PubMed Central  Google Scholar 

  266. Holmqvist F, Guan N, Zhu Z, Kowey PR, Allen LA, Fonarow GC, Hylek EM, Mahaffey KW, Freeman JV, Chang P, Holmes DN, Peterson ED, Piccini JP, Gersh BJ, Investigators O-A. Impact of obstructive sleep apnea and continuous positive airway pressure therapy on outcomes in patients with atrial fibrillation-Results from the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). Am Heart J. 2015;169:647–654.e2.

    Article  PubMed  Google Scholar 

  267. Qureshi WT, Nasir UB, Alqalyoobi S, O’Neal WT, Mawri S, Sabbagh S, Soliman EZ, Al-Mallah MH. Meta-analysis of continuous positive airway pressure as a therapy of atrial fibrillation in obstructive sleep apnea. Am J Cardiol. 2015;116:1767–73.

    Article  PubMed  Google Scholar 

  268. Pathak RK, Evans M, Middeldorp ME, Mahajan R, Mehta AB, Meredith M, Twomey D, Wong CX, Hendriks JML, Abhayaratna WP, Kalman JM, Lau DH, Sanders P. Cost-effectiveness and clinical effectiveness of the risk factor management clinic in atrial fibrillation: the CENT Study. JACC Clin Electrophysiol. 2017;3:436–47.

    Article  PubMed  Google Scholar 

  269. Silberberg A, Tan MK, Yan AT, Angaran P, Dorian P, Bucci C, Gregoire JC, Bell AD, Gladstone DJ, Green MS, Gross PL, Skanes A, Demchuk AM, Kerr CR, Mitchell LB, et al. Use of evidence-based therapy for cardiovascular risk factors in Canadian outpatients with atrial fibrillation: from the Facilitating Review and Education to Optimize Stroke Prevention in Atrial Fibrillation (FREEDOM AF) and Co-ordinated National Network to Engage Physicians in the Care and Treatment of Patients With Atrial Fibrillation (CONNECT AF). Am J Cardiol. 2017;120:582–7.

    Article  PubMed  Google Scholar 

  270. Swedberg K, Zannad F, McMurray JJ, Krum H, van Veldhuisen DJ, Shi H, Vincent J, Pitt B, Investigators E-HS. Eplerenone and atrial fibrillation in mild systolic heart failure: results from the EMPHASIS-HF (Eplerenone in Mild Patients Hospitalization And SurvIval Study in Heart Failure) study. J Am Coll Cardiol. 2012;59:1598–603.

    Article  CAS  PubMed  Google Scholar 

  271. Fatemi O, Yuriditsky E, Tsioufis C, Tsachris D, Morgan T, Basile J, Bigger T, Cushman W, Goff D, Soliman EZ, Thomas A, Papademetriou V. Impact of intensive glycemic control on the incidence of atrial fibrillation and associated cardiovascular outcomes in patients with type 2 diabetes mellitus (from the Action to Control Cardiovascular Risk in Diabetes Study). Am J Cardiol. 2014;114:1217–22.

    Article  PubMed  PubMed Central  Google Scholar 

  272. Alonso A, Bahnson JL, Gaussoin SA, Bertoni AG, Johnson KC, Lewis CE, Vetter M, Mantzoros CS, Jeffery RW, Soliman EZ, Look ARG. Effect of an intensive lifestyle intervention on atrial fibrillation risk in individuals with type 2 diabetes: the Look AHEAD randomized trial. Am Heart J. 2015;170:770–777.e5.

    Article  PubMed  PubMed Central  Google Scholar 

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Authors and Affiliations

  1. National Heart, Lung, and Blood Institute’s Framingham Heart Study, Framingham, Massachusetts & Sections of Cardiovascular Medicine and Preventive Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA

    Jelena Kornej & Emelia J. Benjamin

  2. Department of Epidemiology, Boston University School of Medicine, Boston, MA, USA

    Emelia J. Benjamin

Authors
  1. Jelena Kornej
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  2. Emelia J. Benjamin
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Correspondence to Jelena Kornej .

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  1. Heart Disease Prevention Program, Division of Cardiology, University of California, Irvine, Irvine, CA, USA

    Nathan D. Wong

  2. Division of Cardiovascular Medicine, University of California, Davis, Sacramento, CA, USA

    Ezra A. Amsterdam

  3. Cicarrone Center for the Prevention of Cardiovascular Disease, John Hopkins University School of Medicine, Baltimore, MD, USA

    Peter P. Toth

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Kornej, J., Benjamin, E.J. (2021). Prevention of Atrial Fibrillation. In: Wong, N.D., Amsterdam, E.A., Toth, P.P. (eds) ASPC Manual of Preventive Cardiology. Contemporary Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-030-56279-3_23

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  • DOI: https://doi.org/10.1007/978-3-030-56279-3_23

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