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Review
. 2025 Mar 21;26(3):27175.
doi: 10.31083/RCM27175. eCollection 2025 Mar.

The Influence of Risk Factor Modification on Atrial Fibrillation Outcomes and Their Impact on the Success of Catheter Ablation

Nakul Chandan  1   2 , Vishnu Ashok  1 , Taesoon Hwang  1 , Ven Gee Lim  1   3 , Thomas Lachlan  1   3 , Helen Eftekhari  1   3 , Gordon McGregor  1   2   3 , Faizel Osman  1   2   3
Affiliations
Review

The Influence of Risk Factor Modification on Atrial Fibrillation Outcomes and Their Impact on the Success of Catheter Ablation

Nakul Chandan et al. Rev Cardiovasc Med. .

Abstract

The global prevalence of atrial fibrillation (AF) is growing with a significant increase in AF burden. The pathophysiology of AF is complex and exhibits a strong relationship with modifiable lifestyle AF risk factors, such as physical inactivity, smoking, obesity, and alcohol consumption, as well as co-morbidities, such as hypertension, diabetes mellitus, and cardiovascular disease. Current evidence suggests that cardiac rehabilitation and lifestyle risk factor modification can potentially lower the overall AF burden. Additionally, AF ablation can be an effective treatment for a rhythm control strategy, but reducing AF recurrences post-catheter ablation is paramount. Thus, addressing these modifiable lifestyle risk factors and co-morbidities is critical, as the recent 2024 European Society of Cardiology AF guidance update highlights. A comprehensive approach to treating these risk factors is essential, especially given the rising prevalence of AF. This article provides a state-of-the-art update on the evidence of addressing AF-related risk factors and co-morbidities, particularly in patients undergoing AF ablation.

Keywords: AF ablation outcome; atrial fibrillation; cardiac rehabilitation; risk factor modification.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1.
Fig. 1.
The change in approach to atrial fibrillation management, as demonstrated in the 2024 ESC AF guideline update with prioritization of co-morbidities and AF risk factor management (adapted from the ESC 2024 Guidelines [7]). AF, atrial fibrillation; ESC, European Society of Cardiology.
Fig. 2.
Fig. 2.
Key risk factors for atrial fibrillation and their management targets (adapted from ESC 2024 AF Guidelines [7]). LVEF, left ventricular ejection fraction; SGLTi, sodium-glucose co-transporter 2 inhibitor; AF, atrial fibrillation; ESC, European Society of Cardiology.
Fig. 3.
Fig. 3.
Demonstration of the multi-disciplinary team ‘hub-and-spoke’ approach to the management of patients undergoing an AF ablation procedure. AF, atrial fibrillation.
See this image and copyright information in PMC

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