Comorbidities and factors precipitating atrial fibrillation

Many comorbidities and precipitating factors increase the risk of developing atrial fibrillation, and worsen the prognosis. These includeHindricks, 2021:

• heart failure
• elevated blood pressure
• valvular heart disease
• myocardial ischaemia
• pulmonary embolism
• obstructive sleep apnoea and other lung diseases
• diabetes mellitus
• sepsis
• hyperthyroidism
• surgical stress
• excess body weight
• alcohol use.

In patients with newly diagnosed atrial fibrillation, assessment for and aggressive treatment of these comorbidities and precipitating factors is essential to reduce mortality.

For patients with obesity or who are overweight, long-term sustained weight loss is associated with a significant reduction in the frequency, duration and severity of atrial fibrillation Pathak, 2015.

Substantial reduction of alcohol intake (aiming for fewer than 3 standard drinks per week) reduces recurrence of atrial fibrillation and time spent in atrial fibrillation; however, alcohol cessation is idealVoskoboinik, 2020.