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Atrial fibrillation prevention: an appraisal of current evidence
  1. Giuseppe Boriani1,
  2. Marco Proietti2,3
  1. 1 Cardiology Division, Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Policlinico di Modena, Modena, Italy
  2. 2 Department of Neuroscience, IRCCS–Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
  3. 3 Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
  1. Correspondence to Professor Giuseppe Boriani, Cardiology Division, Department of Diagnostics, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Policlinico di Modena, 41124 Modena, Italy; giuseppe.boriani{at}


Atrial fibrillation (AF), which is the most diagnosed arrhythmia, is becoming a significant issue for health policy-makers. In particular, more and more attention is being devoted to AF prevention. Indeed, several studies recently published point out how targeted interventions could be useful in reducing the risk of AF occurrence (or recurrence). In this review, we briefly summarised the role of the major risk factors associated with the incidence of AF, as well as the effectiveness of interventions aimed at controlling these risk factors. Several general risk factors, such as alcohol consumption, physical activity, smoking habit, as well as specific cardiovascular risk factors as diabetes mellitus, hypertension and obesity have a relevant impact in determining the occurrence of AF, along with a strong clinical evidence of a dose–effect response mechanism for most of the factors examined. Specific interventions aimed at controlling risk factors have been showed to clearly reduce the risk of AF in several cohorts. Even more importantly, integrated programmes aimed at controlling for multiple risk factors would be more efficient in terms of reducing risk of AF, in particular whena stricter control is observed. AF prevention requires a series of initiatives focused on the many risk factors that we reviewed, as well as a more integrated approach, which should involve many stakeholders at different levels. In this light and also considering the constantly changing epidemiology, AF prevention may constitute a future ‘win–win’ strategy for all the stakeholders.

  • atrial fibrillation
  • stroke
  • epidemiology
  • cardiac risk factors and prevention
  • obesity

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  • Contributors Both authors participated substantially to the work and meet all of the following conditions: (1) substantial contributions to the conception and design, acquisition of data or analysis and interpretation of data; (2) drafting the article or revising it critically for important intellectual content; and (3) final approval of the version to be published.

  • Competing interests None declared.

  • Provenance and peer review Commissioned; externally peer reviewed.