The Impact of Diet and Lifestyle on Atrial Fibrillation
Purpose of Review
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in humans, affecting more than 33 million people globally. Its association with complex, resource intensive medical conditions such as stroke, heart failure and dementia have had profound impacts across existing health care structures. The global prevalence of AF has enjoyed significant growth despite significant improvement in our armamentarium for arrhythmia treatment.
Efforts aimed at curtailing the incidence, prevalence, or progression of AF have prompted re-evaluation of traditional frameworks for understanding and managing this debilitating disease. It is in this context that focus has shifted toward lifestyle-associated factors such as obesity, hypertension, sleep apnoea, exercise, alcohol and diet, as mechanistic drivers and putative targets for therapy. Compelling evidence exists for weight loss and management of associated risk factors to improve outcomes of AF treatment.
This review will address the epidemiologic and mechanistic evidence that link lifestyle-associated factors with AF and in light of this analysis evaluate the clinical impacts of their upstream management. Traditional paradigms of AF are shifting in light of emerging evidence, such that risk factor modification has become positioned as the fourth pillar of AF management.
KeywordsAtrial fibrillation Weight loss Risk factor management Diet Exercise Cardio respiratory fitness Alcohol
Compliance with Ethical Standards
Conflict of Interest
C.J. Nalliah and J.M. Kalman declare that they have no conflict of interest.
P. Sanders reports grants, non-financial support and other from Medtronic; grants, non-financial support and other from Abbott; grants, non-financial support and other from Boston-Scientific; other from CathRx; and other from Biosense-Webster. He is also supported by a Practitioner Fellowship from the National Health and Medical Research Council of Australia and also by the National Heart Foundation of Australia.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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