Atrial fibrillation risk factors: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
 
(37 intermediate revisions by 6 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{| class="infobox" style="float:right;"
|-
| [[File:Siren.gif|30px|link=Atrial fibrillation resident survival guide]]|| <br> || <br>
| [[Atrial fibrillation resident survival guide|'''Resident'''<br>'''Survival'''<br>'''Guide''']]
|}
{| class="infobox" style="float:right;"
|-
| [[File:Critical_pathways_.gif|88px|link=Atrial fibrillation critical pathways]]|| <br> || <br>
|}
{| class="infobox" style="float:right;"
|-
| <small>Sinus rhythm</small> [[Image:Heart conduct sinus.gif|none|75px]]
| <small>Atrial fibrillation</small> [[Image:Heart conduct atrialfib.gif|none|100px]]
|}
{{Template:Atrial fibrillation}}
{{Template:Atrial fibrillation}}


{{CMG}}
{{CMG}} {{AE}} {{Anahita}}


==Overview==
==Overview==
The most common cause of atrial fibrillation is atrial dilation associated with [[hypertension]].  Approximately 1/3 of patients have [[familial atrial fibrillation]] which is due to an underlying genetic disorder. Given the number of patients who undergo [[coronary artery bypass grafting]] in the developed world, this is an increasing underlying cause of atrial fibrillation. Other general causes include the advancing age of the population this hemodynamic stress of [[heart failure]] and [[valvular heart disease]], myocardial ischemia, a variety of inflammatory disorders, pulmonary diseases, alcohol and drug abuse, and endocrine disorders.
Numerous [[risk factors]] have been found for [[atrial fibrillation]]. There are some reversible [[risk factors]] such as [[alcohol]] drinking and [[alcohol]] [[withdrawal]], [[caffeine]], [[cocaine]], [[stimulant]] and [[smoking]]. Furthermore [[risk factors]] such as [[hypertension]], [[diabetes]], [[obesity]] and [[sedentary lifestyle]] can be considered as reversible conditions that can increase the chance of [[atrial fibrillation]] development. On the other hand [[risk factors]] such as [[hypertrophic obstructive cardiomyopathy]], [[heart failure]], [[chronic renal failure]] and positive [[familial history]] have been introduced as irreversible [[risk factors]] in [[atrial fibrillation]]. There are also conditions that have been recognized as [[risk factors]] for [[ischemia|ischemic]] [[stroke]] or systemic embolization in [[patients]] with [[atrial fibrillation|non-valvular atrial fibrillation]], such as [[Old age|advanced age]], impaired [[left ventricle|left ventricular]] systolic function, [[hypertension]] and [[diabetes]]. [[male|Male sex]], [[Diuretic|diuretic use]] and [[heart|cardiac]] or [[thoracic surgery]] are also among other known [[risk factors]].


==Reversible or Modifiable Underlying Conditions Associated with Atrial Fibrillation==
==Risk Factors==
===Reversible or Modifiable Underlying Conditions Associated with Atrial Fibrillation===
*[[Alcohol]] and [[alcohol withdrawal]]
*[[Alcohol]] and [[alcohol withdrawal]]
*Breath spray which contains alcohol <ref name="pmid2914028">{{cite journal| author=Ridker PM, Gibson CM, Lopez R| title=Atrial fibrillation induced by breath spray. | journal=N Engl J Med | year= 1989 | volume= 320 | issue= 2 | pages= 124 | pmid=2914028 | doi= | pmc= | url= }} </ref>
*[[Breath spray]] which contains [[alcohol]] <ref name="pmid2914028">{{cite journal| author=Ridker PM, Gibson CM, Lopez R| title=Atrial fibrillation induced by breath spray. | journal=N Engl J Med | year= 1989 | volume= 320 | issue= 2 | pages= 124 | pmid=2914028 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2914028  }} </ref>
*[[Caffeine]] (coffee or tea)
*[[Caffeine]] ([[coffee]] or [[tea]])
*[[Cocaine]]
*[[Cocaine]]
*[[Coronary Artery Bypass Graft Surgery]]
*[[Smoking]]<ref name="pmid11156892">{{cite journal| author=Allessie MA, Boyden PA, Camm AJ, Kléber AG, Lab MJ, Legato MJ | display-authors=etal| title=Pathophysiology and prevention of atrial fibrillation. | journal=Circulation | year= 2001 | volume= 103 | issue= 5 | pages= 769-77 | pmid=11156892 | doi=10.1161/01.cir.103.5.769 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11156892  }} </ref><ref name="pmid28450367">{{cite journal| author=Staerk L, Sherer JA, Ko D, Benjamin EJ, Helm RH| title=Atrial Fibrillation: Epidemiology, Pathophysiology, and Clinical Outcomes. | journal=Circ Res | year= 2017 | volume= 120 | issue= 9 | pages= 1501-1517 | pmid=28450367 | doi=10.1161/CIRCRESAHA.117.309732 | pmc=5500874 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28450367  }} </ref>
*Esophageal surgery
*[[Coronary artery bypass graft surgery]]
*[[Esophagus|Esophageal]] [[surgery]] <ref name="pmid11156892">{{cite journal| author=Allessie MA, Boyden PA, Camm AJ, Kléber AG, Lab MJ, Legato MJ | display-authors=etal| title=Pathophysiology and prevention of atrial fibrillation. | journal=Circulation | year= 2001 | volume= 103 | issue= 5 | pages= 769-77 | pmid=11156892 | doi=10.1161/01.cir.103.5.769 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11156892  }} </ref>
*[[Hyperthyroidism]]
*[[Hyperthyroidism]]
*[[Hypertension]]<ref name="pmid28450367">{{cite journal| author=Staerk L, Sherer JA, Ko D, Benjamin EJ, Helm RH| title=Atrial Fibrillation: Epidemiology, Pathophysiology, and Clinical Outcomes. | journal=Circ Res | year= 2017 | volume= 120 | issue= 9 | pages= 1501-1517 | pmid=28450367 | doi=10.1161/CIRCRESAHA.117.309732 | pmc=5500874 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28450367  }} </ref>
*[[Diabetes]] <ref name="pmid28450367">{{cite journal| author=Staerk L, Sherer JA, Ko D, Benjamin EJ, Helm RH| title=Atrial Fibrillation: Epidemiology, Pathophysiology, and Clinical Outcomes. | journal=Circ Res | year= 2017 | volume= 120 | issue= 9 | pages= 1501-1517 | pmid=28450367 | doi=10.1161/CIRCRESAHA.117.309732 | pmc=5500874 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28450367  }} </ref>
*[[Obesity]] <ref name="pmid28450367">{{cite journal| author=Staerk L, Sherer JA, Ko D, Benjamin EJ, Helm RH| title=Atrial Fibrillation: Epidemiology, Pathophysiology, and Clinical Outcomes. | journal=Circ Res | year= 2017 | volume= 120 | issue= 9 | pages= 1501-1517 | pmid=28450367 | doi=10.1161/CIRCRESAHA.117.309732 | pmc=5500874 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28450367  }} </ref>
*[[Hypomagnesemia]]<ref name="pmid23172839">{{cite journal| author=May Khan A, Lubitz SA, Sullivan LM, Sun JX, Levy D, Vasan RS et al.| title=Low Serum Magnesium and the Development of Atrial Fibrillation in the Community: The Framingham Heart Study. | journal=Circulation | year= 2012 | volume=  | issue=  | pages=  | pmid=23172839 | doi=10.1161/CIRCULATIONAHA.111.082511 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23172839  }} </ref>
*[[Hypothermia]]
*[[Hypothermia]]
*[[Hypothyroidism]]
*[[Hypothyroidism]]
*[[Hypoxia]]
*[[Hypoxia]]
*[[Pericarditis]] and pericardial disease in general
*[[Pericarditis]] and [[Pericarditis|pericardial disease]] in general
*[[Pheochromocytoma]]
*[[Pheochromocytoma]]
*[[Pulmonary embolism]]
*[[Pulmonary embolism]]
*[[Stimulants]]
*[[Stimulants]]
*[[Sedentary lifestyle]] <ref name="pmid28450367">{{cite journal| author=Staerk L, Sherer JA, Ko D, Benjamin EJ, Helm RH| title=Atrial Fibrillation: Epidemiology, Pathophysiology, and Clinical Outcomes. | journal=Circ Res | year= 2017 | volume= 120 | issue= 9 | pages= 1501-1517 | pmid=28450367 | doi=10.1161/CIRCRESAHA.117.309732 | pmc=5500874 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28450367  }} </ref>
*[[Sleep apnea]] <ref name="pmid28450367">{{cite journal| author=Staerk L, Sherer JA, Ko D, Benjamin EJ, Helm RH| title=Atrial Fibrillation: Epidemiology, Pathophysiology, and Clinical Outcomes. | journal=Circ Res | year= 2017 | volume= 120 | issue= 9 | pages= 1501-1517 | pmid=28450367 | doi=10.1161/CIRCRESAHA.117.309732 | pmc=5500874 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28450367  }} </ref>


==Irreversible Underlying Conditions Associated with Atrial Fibrillation==
===Irreversible Underlying Conditions Associated with Atrial Fibrillation===
*[[Hypertrophic Obstructive Cardiomyopathy]]
*[[Hypertrophic Obstructive Cardiomyopathy]] <ref name="pmid11156892">{{cite journal| author=Allessie MA, Boyden PA, Camm AJ, Kléber AG, Lab MJ, Legato MJ | display-authors=etal| title=Pathophysiology and prevention of atrial fibrillation. | journal=Circulation | year= 2001 | volume= 103 | issue= 5 | pages= 769-77 | pmid=11156892 | doi=10.1161/01.cir.103.5.769 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11156892  }} </ref>
*[[Heart failure]]<ref name="pmid21920917">{{cite journal| author=Chamberlain AM, Redfield MM, Alonso A, Weston SA, Roger VL| title=Atrial fibrillation and mortality in heart failure: a community study. | journal=Circ Heart Fail | year= 2011 | volume= 4 | issue= 6 | pages= 740-6 | pmid=21920917 | doi=10.1161/CIRCHEARTFAILURE.111.962688 | pmc=3222889 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21920917  }} </ref>
*[[Short QT syndrome]]
*[[Short QT syndrome]]
*[[Chronic renal failure]]<ref name="pmid22949543">{{cite journal| author=McManus DD, Rienstra M, Benjamin EJ| title=An update on the prognosis of patients with atrial fibrillation. | journal=Circulation | year= 2012 | volume= 126 | issue= 10 | pages= e143-6 | pmid=22949543 | doi=10.1161/CIRCULATIONAHA.112.129759 | pmc=3678907 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22949543  }} </ref>
*[[Coronary heart disease|Ischemia heart disease]]<ref name="pmid11156892">{{cite journal| author=Allessie MA, Boyden PA, Camm AJ, Kléber AG, Lab MJ, Legato MJ | display-authors=etal| title=Pathophysiology and prevention of atrial fibrillation. | journal=Circulation | year= 2001 | volume= 103 | issue= 5 | pages= 769-77 | pmid=11156892 | doi=10.1161/01.cir.103.5.769 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11156892  }} </ref>
*Familial history <ref name="pmid20551423">{{cite journal| author=Lubitz SA, Ozcan C, Magnani JW, Kääb S, Benjamin EJ, Ellinor PT| title=Genetics of atrial fibrillation: implications for future research directions and personalized medicine. | journal=Circ Arrhythm Electrophysiol | year= 2010 | volume= 3 | issue= 3 | pages= 291-9 | pmid=20551423 | doi=10.1161/CIRCEP.110.942441 | pmc=3062900 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20551423  }} </ref>


==Risk Stratification==
===Risk Stratification===
*Once a patient develops atrial fibrillation, their risk of subsequent events can be assessed using the following tow scores:
*Once a patient develops atrial fibrillation, their risk of subsequent events can be assessed using the following scores:
=====[[CHADS Score|CHADS2 Score]]=====
**[[CHADS Score|CHADS2 Score]]
=====[[CHA2DS2-VASc Score]]=====
**[[CHA2DS2-VASc Score]]


*The risk of bleeding associated with anticoagulation can be assessed using the following score:
*The risk of bleeding associated with anticoagulation can be assessed using the following score:
=====[[HAS-BLED score]]=====
**[[HAS-BLED score]]


==Risk factors for Ischemic Stroke or Systemic Embolization in Patients with Non-valvular Atrial Fibrillation==
===Risk factors for Ischemic Stroke or Systemic Embolization in Patients with Non-valvular Atrial Fibrillation===
Numbers represents relative risks <ref name="pmid18283199">Estes NA, Halperin JL, Calkins H, Ezekowitz MD, Gitman P, Go AS et al. (2008) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=18283199 ACC/AHA/Physician Consortium 2008 clinical performance measures for adults with nonvalvular atrial fibrillation or atrial flutter: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and the Physician Consortium for Performance Improvement (Writing Committee to Develop Clinical Performance Measures for Atrial Fibrillation): developed in collaboration with the Heart Rhythm Society.] ''Circulation'' 117 (8):1101-20. [http://dx.doi.org/10.1161/CIRCULATIONAHA.107.187192 DOI:10.1161/CIRCULATIONAHA.107.187192] PMID: [http://pubmed.gov/18283199 18283199]</ref>
[[Risk factors]] and relative risks are tabulated below: <ref name="pmid18283199">Estes NA, Halperin JL, Calkins H, Ezekowitz MD, Gitman P, Go AS et al. (2008) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=18283199 ACC/AHA/Physician Consortium 2008 clinical performance measures for adults with nonvalvular atrial fibrillation or atrial flutter: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and the Physician Consortium for Performance Improvement (Writing Committee to Develop Clinical Performance Measures for Atrial Fibrillation): developed in collaboration with the Heart Rhythm Society.] ''Circulation'' 117 (8):1101-20. [http://dx.doi.org/10.1161/CIRCULATIONAHA.107.187192 DOI:10.1161/CIRCULATIONAHA.107.187192] PMID: [http://pubmed.gov/18283199 18283199]</ref><ref name="pmid18397874">{{cite journal| author=Nieuwlaat R, Prins MH, Le Heuzey JY, Vardas PE, Aliot E, Santini M | display-authors=etal| title=Prognosis, disease progression, and treatment of atrial fibrillation patients during 1 year: follow-up of the Euro Heart Survey on atrial fibrillation. | journal=Eur Heart J | year= 2008 | volume= 29 | issue= 9 | pages= 1181-9 | pmid=18397874 | doi=10.1093/eurheartj/ehn139 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18397874  }} </ref><ref name="pmid11156892">{{cite journal| author=Allessie MA, Boyden PA, Camm AJ, Kléber AG, Lab MJ, Legato MJ | display-authors=etal| title=Pathophysiology and prevention of atrial fibrillation. | journal=Circulation | year= 2001 | volume= 103 | issue= 5 | pages= 769-77 | pmid=11156892 | doi=10.1161/01.cir.103.5.769 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11156892  }} </ref>
#Advanced age (continuous, per decade)                                           1.4
 
#History of [[hypertension]]                                                     1.6
{|class="wikitable"
#[[Heart failure]] or impaired left ventricular systolic function                 1.4
|-
#[[Coronary artery disease]] (CAD)                                               1.5
| '''Risk Factor''' || '''Relative Risk'''
#[[Diabetes mellitus]] (DM)                                                       1.7
|-
#Previous [[stroke]] or [[Transient Ischemic Attack]] (TIA)                       2.5
| [[Old age|Advanced age]] (continuous, per decade)                                         || <center> 1.4</center>
|-
| History of [[hypertension]]                                                   ||  <center> 1.6</center>
|-
| [[Heart failure]] or impaired [[left ventricle|left ventricular]] systolic function               ||  <center> 1.4</center>
|-
| [[Coronary artery disease]] ([[Coronary artery disease|CAD]])                                             ||  <center> 1.5</center>
|-
| [[Diabetes mellitus]] ([[Diabetes mellitus|DM]])                                                     ||  <center> 1.7</center>
|-
| Previous [[stroke]] or [[Transient Ischemic Attack]] ([[Transient Ischemic Attack|TIA]])                     ||  <center> 2.5</center>
|}
 
===Other Risk Factors===
*[[male|Male sex]] <ref name="pmid11156892">{{cite journal| author=Allessie MA, Boyden PA, Camm AJ, Kléber AG, Lab MJ, Legato MJ | display-authors=etal| title=Pathophysiology and prevention of atrial fibrillation. | journal=Circulation | year= 2001 | volume= 103 | issue= 5 | pages= 769-77 | pmid=11156892 | doi=10.1161/01.cir.103.5.769 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11156892  }} </ref>
*[[Diuretic|Diuretic use]] <ref name="pmid11156892">{{cite journal| author=Allessie MA, Boyden PA, Camm AJ, Kléber AG, Lab MJ, Legato MJ | display-authors=etal| title=Pathophysiology and prevention of atrial fibrillation. | journal=Circulation | year= 2001 | volume= 103 | issue= 5 | pages= 769-77 | pmid=11156892 | doi=10.1161/01.cir.103.5.769 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11156892  }} </ref>
*[[heart|Cardiac]] or [[thoracic surgery]] <ref name="pmid11156892">{{cite journal| author=Allessie MA, Boyden PA, Camm AJ, Kléber AG, Lab MJ, Legato MJ | display-authors=etal| title=Pathophysiology and prevention of atrial fibrillation. | journal=Circulation | year= 2001 | volume= 103 | issue= 5 | pages= 769-77 | pmid=11156892 | doi=10.1161/01.cir.103.5.769 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11156892  }} </ref>


==Reference==
==Reference==
{{reflist|2}}
{{Reflist|2}}


{{WH}}
{{WH}}
{{WS}}
{{WS}}
[[CME Category::Cardiology]]


[[Category:Cardiology]]
[[Category:Cardiology]]
[[Category:Electrophysiology]]
[[Category:Electrophysiology]]
[[Category:Emergency medicine]]
[[Category:Emergency medicine]]
[[Category:Up-To-Date]]
[[Category:Up-To-Date cardiology]]

Latest revision as of 04:20, 30 August 2021
Resident
Survival
Guide


Sinus rhythm
Atrial fibrillation

Atrial Fibrillation Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Atrial Fibrillation from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Special Groups

Postoperative AF
Acute Myocardial Infarction
Wolff-Parkinson-White Preexcitation Syndrome
Hypertrophic Cardiomyopathy
Hyperthyroidism
Pulmonary Diseases
Pregnancy
ACS and/or PCI or valve intervention
Heart failure

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

EKG Examples
A-Fib with LBBB

Chest X Ray

Echocardiography

Holter Monitoring and Exercise Stress Testing

Cardiac MRI

Treatment

Rate and Rhythm Control

Cardioversion

Overview
Electrical Cardioversion
Pharmacological Cardioversion

Anticoagulation

Overview
Warfarin
Converting from or to Warfarin
Converting from or to Parenteral Anticoagulants
Dabigatran

Maintenance of Sinus Rhythm

Surgery

Catheter Ablation
AV Nodal Ablation
Surgical Ablation
Cardiac Surgery

Specific Patient Groups

Primary Prevention

Secondary Prevention

Supportive Trial Data

Cost-Effectiveness of Therapy

Case Studies

Case #1

Atrial fibrillation risk factors On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Atrial fibrillation risk factors

CDC on Atrial fibrillation risk factors

Atrial fibrillation risk factors in the news

Blogs on Atrial fibrillation risk factors

Directions to Hospitals Treating Atrial fibrillation risk factors

Risk calculators and risk factors for Atrial fibrillation risk factors

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]

Overview

Numerous risk factors have been found for atrial fibrillation. There are some reversible risk factors such as alcohol drinking and alcohol withdrawal, caffeine, cocaine, stimulant and smoking. Furthermore risk factors such as hypertension, diabetes, obesity and sedentary lifestyle can be considered as reversible conditions that can increase the chance of atrial fibrillation development. On the other hand risk factors such as hypertrophic obstructive cardiomyopathy, heart failure, chronic renal failure and positive familial history have been introduced as irreversible risk factors in atrial fibrillation. There are also conditions that have been recognized as risk factors for ischemic stroke or systemic embolization in patients with non-valvular atrial fibrillation, such as advanced age, impaired left ventricular systolic function, hypertension and diabetes. Male sex, diuretic use and cardiac or thoracic surgery are also among other known risk factors.

Risk Factors

Reversible or Modifiable Underlying Conditions Associated with Atrial Fibrillation

Irreversible Underlying Conditions Associated with Atrial Fibrillation

Risk Stratification

  • Once a patient develops atrial fibrillation, their risk of subsequent events can be assessed using the following scores:
  • The risk of bleeding associated with anticoagulation can be assessed using the following score:

Risk factors for Ischemic Stroke or Systemic Embolization in Patients with Non-valvular Atrial Fibrillation

Risk factors and relative risks are tabulated below: [8][9][2]

Risk Factor Relative Risk
Advanced age (continuous, per decade)
1.4
History of hypertension
1.6
Heart failure or impaired left ventricular systolic function
1.4
Coronary artery disease (CAD)
1.5
Diabetes mellitus (DM)
1.7
Previous stroke or Transient Ischemic Attack (TIA)
2.5

Other Risk Factors

Reference

  1. ↑ Ridker PM, Gibson CM, Lopez R (1989). "Atrial fibrillation induced by breath spray". N Engl J Med. 320 (2): 124. PMID 2914028.
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 2.7 Allessie MA, Boyden PA, Camm AJ, Kléber AG, Lab MJ, Legato MJ; et al. (2001). "Pathophysiology and prevention of atrial fibrillation". Circulation. 103 (5): 769–77. doi:10.1161/01.cir.103.5.769. PMID 11156892.
  3. ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Staerk L, Sherer JA, Ko D, Benjamin EJ, Helm RH (2017). "Atrial Fibrillation: Epidemiology, Pathophysiology, and Clinical Outcomes". Circ Res. 120 (9): 1501–1517. doi:10.1161/CIRCRESAHA.117.309732. PMC 5500874. PMID 28450367.
  4. ↑ May Khan A, Lubitz SA, Sullivan LM, Sun JX, Levy D, Vasan RS; et al. (2012). "Low Serum Magnesium and the Development of Atrial Fibrillation in the Community: The Framingham Heart Study". Circulation. doi:10.1161/CIRCULATIONAHA.111.082511. PMID 23172839.
  5. ↑ Chamberlain AM, Redfield MM, Alonso A, Weston SA, Roger VL (2011). "Atrial fibrillation and mortality in heart failure: a community study". Circ Heart Fail. 4 (6): 740–6. doi:10.1161/CIRCHEARTFAILURE.111.962688. PMC 3222889. PMID 21920917.
  6. ↑ McManus DD, Rienstra M, Benjamin EJ (2012). "An update on the prognosis of patients with atrial fibrillation". Circulation. 126 (10): e143–6. doi:10.1161/CIRCULATIONAHA.112.129759. PMC 3678907. PMID 22949543.
  7. ↑ Lubitz SA, Ozcan C, Magnani JW, Kääb S, Benjamin EJ, Ellinor PT (2010). "Genetics of atrial fibrillation: implications for future research directions and personalized medicine". Circ Arrhythm Electrophysiol. 3 (3): 291–9. doi:10.1161/CIRCEP.110.942441. PMC 3062900. PMID 20551423.
  8. ↑ Estes NA, Halperin JL, Calkins H, Ezekowitz MD, Gitman P, Go AS et al. (2008) ACC/AHA/Physician Consortium 2008 clinical performance measures for adults with nonvalvular atrial fibrillation or atrial flutter: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and the Physician Consortium for Performance Improvement (Writing Committee to Develop Clinical Performance Measures for Atrial Fibrillation): developed in collaboration with the Heart Rhythm Society. Circulation 117 (8):1101-20. DOI:10.1161/CIRCULATIONAHA.107.187192 PMID: 18283199
  9. ↑ Nieuwlaat R, Prins MH, Le Heuzey JY, Vardas PE, Aliot E, Santini M; et al. (2008). "Prognosis, disease progression, and treatment of atrial fibrillation patients during 1 year: follow-up of the Euro Heart Survey on atrial fibrillation". Eur Heart J. 29 (9): 1181–9. doi:10.1093/eurheartj/ehn139. PMID 18397874.

Template:WH Template:WS CME Category::Cardiology

Retrieved from "https://www.wikidoc.org/index.php?title=Atrial_fibrillation_risk_factors&oldid=1712487"