Risk factors for atrial fibrillation incidence and progression

During atrial fibrillation (AF) irregular activation of the hearts atria occur, causing an irregular heart rate and altered blood flow. AF is the most common heart rhythm disorder, causing stroke, heart failure, dementia, reduced quality of life and high health care expences. AF is diagnosed increasingly frequent, at increasingly young age. Treatment requires knowledge on factors that may cause AF, which may help prevent occurence of AF and AF progression. AF progression is the proces by which scar tissue forms in the atria, which goes hand-in-hand with increased episodes of AF and AF-related complications. Examples of traditional risk factors for AF are hypertension, heart infarction and heart failure. However risk factors are changing because of improved treatment, increasing age of the population and changing lifestyle. We investigated risk factors for AF incidence and progression. We found that obesity nowadays has become an important risk factor for atrial fibrillation occurrence, at both younger age (<60 years) and older age. At younger age heritable factors seem to be more important than at older age, conversely, some traditional risk factors are less important at younger age. Furthermore, presence of AF related symtoms (e.g. shortness of breath) may be a sign of present risk factors, more AF related complications and therefore AF progression. Finally, we found that even in young patients with AF and obesity, atrial function is reduced, which is an early sign of scar tissue formation. This again underlines that AF treatment should embrace lifestyle change and weightloss