Prevention of atrial fibrillation (AF) requires attention to reducing individual risk factors. Behavioral risk factors
- Diet
- Opulent meal (sumptuous food)
- Micronutrient deficiency (vital substances) – see Prevention with micronutrients.
- Consumption of stimulants
- Alcohol (woman: > 15 g/day; man: > 20 g/day)
- Tobacco (smoking)
- Also passive smoking during childhood: 14.3% developed atrial fibrillation (VHF) a mean of 40.5 years after reaching adulthood; passing on the smoking habit to children resulted in a 34% increased risk of developing VHF in them
- Energy drinks (containing 400 mg/100 ml taurine and 32 mg/100 ml caffeine) – significant prolongations of the QTc interval and increase in systolic blood pressure.
- Physical activity
- Physical inactivity
- Physical overload
- Competitive sports
- VHF is more common in competitive “middle-aged and older endurance athletes with long training history” (51 ± 9 years), probably because of left atrial overstretching; the higher the training intensity, the higher the VHF risk
- Strength-based competitive sports such as American football – former National Football League (NFL) players were 6 times more likely to suffer from VCF than men in a population-based control group
- Psycho-social situation
- Trouble
- Emotional stress
- Frequent sleep deprivation/poor sleep quality (insomnia/sleep disorder).
- Bereavement (41% increased risk of VCF 30 days after bereavement; 1.34-fold increased risk for those under 60 years of age)
- Weekly work hours > 55 hours (1.4-fold increased risk).
- Overweight (BMI ≥ 25; obesity).
- Excessive body mass index (BMI) was responsible for approximately 20% of cases with VCF:
- BMI in men: 31% increased risk.
- BMI in women: 18% increased risk
- Excessive body mass index (BMI) was responsible for approximately 20% of cases with VCF:
Environmental pollution – intoxications (poisonings).
- Noise
- Low temperatures
Other risk factors
- Acute alcohol intoxication (alcohol poisoning).
- After surgical procedures, especially cardiac surgery, atrial fibrillation is a common complication; it is more common in mitral valve procedures (up to 73%) than in bypass surgery (10-33%)
Prevention factors (protective factors)
- Genetic factors:
- Genetic risk reduction depending on gene polymorphisms:
- Genes/SNPs (single nucleotide polymorphism; English : single nucleotide polymorphism):
- Gene: LOC729065
- SNP: rs10033464 in an intergenic region.
- Allele constellation: GG (0.92-fold).
- SNP: rs2200733 in gene LOC729065
- Allele constellation: CC (0.86-fold).
- Genes/SNPs (single nucleotide polymorphism; English : single nucleotide polymorphism):
- Genetic risk reduction depending on gene polymorphisms:
- Chocolate (dark chocolate) due toflavanols from the cocoa beans.
- Physical activity:
- To prevent atrial fibrillation, light to moderately strenuous activities such as running, golfing, and gardening seem appropriate.
- Physically active women have a lower risk of atrial fibrillation than physically active men (hazard ratio [HR] for 1500 vs 0 MET-min/week: 0.85 for women vs 0.90 for men); this is true for exercise-active women at weekly activity volumes of up to 2. 500 MET-min/week (MET stands for metabolic equivalent; 600 MET-min is achieved by about 150 minutes of brisk walking or 75 minutes of running); men, on the other hand, had a low risk only up to an activity volume of about 2,000 MET-min/week; when exceeded, this was already associated with an increased risk of AF.
Secondary prevention
- Alcohol abstinence (abstaining from alcohol): significantly reduces number and duration of arrhythmias.In the abstinence group, 37 of 70 patients (53%) experienced at least one recurrence of AF compared with 51 of 70 patients (73%) in the control group
- Beta-blockers protect against stress-induced atrial fibrillation: While stress and anger significantly increased the risk of AF (odds ratio 22.5), the effect was much smaller in patients taking beta-blockers, with an odds ratio of 4.0.
Operative Prophylaxis:
- Stent implantations in the carotids.
- Occlusion of the left atrial appendage (LAA) – more than 90% of thromboembolism in nonvalvular atrial fibrillation originates from the left atrial appendage
- Closure of the persistent foramen ovale (PFO); this allows a cardiac right-to-left shunt at the atrial level; incidence: approximately 25% of all people; three studies show that PFO closure leads to a significant reduction in recurrent ischemic stroke:
- CLOSE:
- GoreREduce:
- In the group with PFO closure, ischemic stroke recurrences were registered in six patients (1.4%) and in 12 patients (5.4%) in the group with platelet inhibition alone (= significant relative risk reduction of 77% corresponds to (HR 0.23, p=0.002))
- RESPECT:
- Risk of any ischemic stroke recurrence was relatively reduced by 45% with PFO closure (18 vs. 28 events; HR 0.55, p=0.046)