Risk factors of atrial fibrillation and their modification: a new look at a long-term problem

Atrial fibrillation (AF) is one of the most common arrhythmias diagnosed in clinical practice. Today, AF is associated with an increased risk of mortality, acute brain disorders, and heart failure. The results of many studies suggest that the incidence of AF is directly related to such risk factors (RF) as age, obesity, hypertension, diabetes mellitus, obstructive sleep apnea, alcohol, tobacco smoking etc. Recently published studies have described the positive impact of lifestyle changes on the incidence of AF. Therefore, it is believed that early detection of RF could prevent or delay the onset of AF. New data suggest the need to review the management of patients with AF. In 2020, the American Heart Association has presented a scientific statement that highlighted the relationship between modified RF and AF, discussed the implementation of strategies for effective modification of RF, as well as identified areas for new research. The data allow us to conclude that the correction of RF helps to reduce the incidence of AF. Future research is needed to establish the effects and generalizability of systematic lifestyle and RF modification for AF: to study the role of pericardial/epicardial fat accumulation in risk and progression of AF; determination of the most effective weight loss techniques for long-term success in reducing AF; effects of high-intensity/short-duration interval training on left atrium structural and electric remodeling; the degree of glycemic control for AF.