Prevention of Atrial Fibrillation

Abstract

Abstract-The National Heart, Lung, and Blood Institute convened an expert panel April 28 to 29, 2008, to identify gaps and recommend research strategies to prevent atrial fibrillation (AF). The panel reviewed the existing basic scientific, epidemiological, and clinical literature about AF and identified opportunities to advance AF prevention research. After discussion, the panel proposed the following recommendations: (1) enhance understanding of the epidemiology of AF in the population by systematically and longitudinally investigating symptomatic and asymptomatic AF in cohort studies; (2) improve detection of AF by evaluating the ability of existing and emerging methods and technologies to detect AF; (3) improve noninvasive modalities for identifying key components of cardiovascular remodeling that promote AF, including genetic, fibrotic, autonomic, structural, and electrical remodeling markers; (4) develop additional animal models reflective of the pathophysiology of human AF; (5) conduct secondary analyses of already-completed clinical trials to enhance knowledge of potentially effective methods to prevent AF and routinely include AF as an outcome in ongoing and future cardiovascular studies; and (6) conduct clinical studies focused on secondary prevention of AF recurrence, which would inform future primary prevention investigations. Key Words: atrial fibrillation Ⅲ atrium Ⅲ epidemiology Ⅲ prevention Ⅲ risk factors Ⅲ National Heart, Lung, and Blood Institute A trial fibrillation (AF) is the most common arrhythmia in the United States and other developed countries. AF is associated with significant morbidity and mortality, including a 4-to 5-fold increased risk for stroke, 1,2 a doubling of risk for dementia, 3,4 a tripling of risk for heart failure, 2 and a 40% to 90% increased risk for overall mortality. 2,5 Growth in the size of the AF population and increased recognition of the morbidity, mortality, diminished quality of life, and high healthcare costs associated with AF have spurred numerous investigations to develop more effective treatments for AF and its complications. Many risk factors for AF have been described, and some promising preventive strategies have been identified. However, although AF treatment has been studied extensively, AF prevention has received relatively little attention. Over the last 10 years, PubMed has contained almost 4 times as many citations for atrial fibrillation treatment as for atrial fibrillation prevention. When stroke was excluded from the search, citations related to treatment outnumbered those for prevention by Ϸ7-fold.

Ectopy on a Single 12‐Lead ECG, Incident Cardiac Myopathy, and Death in the Community

“…Because of the lack of clear preventive strategies, increasing prevalence, and high morbidity and mortality associated with AF,1, 23 there is increasing interest in identifying clinically accessible and modifiable risk factors 3. PACs have been shown to be critical to AF pathogenesis and AF ablation is built on the premise that triggers or PACs arising in pulmonary veins initiate AF, suggesting that PACs may be a modifiable risk factor for AF in particular subsets of patients 9, 24.…”

“…Identification of high‐risk groups and strategies to facilitate primary prevention of AF and HF using widely accessible methods are critical 3, 4…”

Plasma Concentrations and Dietary Intakes of Choline and Betaine in Association With Atrial Fibrillation Risk: Results From 3 Prospective Cohorts With Different Health Profiles

“…Atrial fibrillation (AF) is the most common clinically relevant cardiac arrhythmia linked to excess morbidity and mortality 1. It has emerged as a global epidemic due to progressively increasing incidence and prevalence worldwide, with developed countries having a greater burden 2.…”

Identification of Features for Machine Learning Analysis for Automatic Arrhythmogenic Event Classification

“…Although, detection of AF is the first step to eliminate the side effect [4], AF detection and specifically automatic detection remains problematic, because it may be episodic. The classic methods for automatic detection of AF relate to the analysis of the absence of P waves.…”