Atrial Fibrillation

Clinical service organisation for adults with atrial fibrillation: Cochrane systematic review and meta-analysis.

Ferguson C, Shaikh F, Allida SM, Hendriks J, Gallagher C, Bajorek BV · European journal of cardiovascular nursing · 2025 · n=8205

This study aims to assess the effects of organized clinical service delivery models for atrial fibrillation (AF) on all-cause mortality and hospitalization, as well as cardiovascular outcomes, thromboembolic events, bleeding complications, quality of life, symptom burden, healthcare costs, and length of hospital stay. A systematic search was conducted across several databases, including Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and CINAHL, and clinical trial registries. Randomized controlled trials involving adults (≥18 years) with any type of AF were included. Primary outcomes were all-cause mortality and all-cause hospitalization. Secondary outcomes included cardiovascular mortality and hospitalization, AF-related emergency department visits, thromboembolic and bleeding events, quality of life, symptom burden, cost of intervention, and length of hospital stay. Eight studies (8205 participants) investigating collaborative, multidisciplinary, or

Left atrial appendage closure vs oral anticoagulation for stroke prevention in atrial fibrillation: Long-term outcomes from 4 randomized trials.

Kaisaier W, Xu Z, Guo L, Dong Y, Chen Y, Lip GYH · Heart rhythm · 2025 · n=3116

Left atrial appendage closure (LAAC) is primarily indicated for stroke prevention in patients with atrial fibrillation (AF) who have contraindications to long-term oral anticoagulants (OACs). However, the long-term comparative benefits of LAAC vs OACs in the broader AF population remain unclear. To study aimed to assess the long-term efficacy and safety of LAAC compared with OACs in patients with AF, we conducted a meta-analysis of randomized controlled trials (RCTs). We systematically searched PubMed, Embase, and Cochrane Library for eligible RCTs. Risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using fixed-effects models. Four RCTs involving 3116 patients with AF (1736 assigned to LAAC and 1380 to OACs) and follow-up durations ranging from 36 to 49.6 months were included. Compared with OACs, LAAC was associated with reduced risks of all-cause death (RR = 0.78; 95% CI: 0.64-0.95) and cardiovascular or unexplained death (RR = 0.69; 95% CI: 0.51-0.94). There wer

Omega-3 and Risk of atrial fibrillation: Vagally-mediated double-edged sword.

O'Keefe EL, O'Keefe JH, Abuissa H, Metzinger M, Murray E, Franco G · Progress in cardiovascular diseases · 2025

Studies regarding effects of omega-3 fatty acids, specifically eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), on risk of atrial fibrillation (AF) have reported discordant results. The aim of this review is to clarify effects of marine omega-3 intake on risk of AF. A PubMed search was performed using terms: atrial fibrillation, omega-3, EPA, DHA, vagal tone. We summarized findings from randomized clinical trials (RCTs), epidemiology studies, and meta-analyses evaluating effects/associations of DHA + EPA on risk of AF. Also, vagal tone was explored as a mediator between omega-3 and risk of AF. Meta-analyses of 8 RCTs and 17 prospective cohort studies comprised of 83,112 and 54,799 individuals, respectively, investigated the link between omega-3 intake and incident AF. The RCTs reported that treatment with DHA and/or EPA was associated with a 24 % increased relative risk of AF (absolute risk 4.0 % vs 3.3 %; relative risk [RR] 1.24, 95 % confide

Umbrella review and Delphi study on modifiable factors for dementia risk reduction.

Rosenau C, Köhler S, Soons LM, Anstey KJ, Brayne C, Brodaty H · Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024

A 2013 systematic review and Delphi consensus study identified 12 modifiable risk and protective factors for dementia, which were subsequently merged into the "LIfestyle for BRAin health" (LIBRA) score. We systematically evaluated whether LIBRA requires revision based on new evidence. To identify modifiable risk and protective factors suitable for dementia risk reduction, we combined an umbrella review of systematic reviews and meta-analyses with a two-round Delphi consensus study. The review of 608 unique primary studies and opinions of 18 experts prioritized six modifiable factors: hearing impairment, social contact, sleep, life course inequalities, atrial fibrillation, and psychological stress. Based on expert ranking, hearing impairment, social contact, and sleep were considered the most suitable candidates for inclusion in updated dementia risk scores. As such, the current study shows that dementia risk scores need systematic updates based on emerging evidence. Future studies will

Modifiable risk factors for incident dementia and cognitive impairment: An umbrella review of evidence.

Zhang YR, Xu W, Zhang W, Wang HF, Ou YN, Qu Y · Journal of affective disorders · 2022

Dementia and cognitive impairment can be attributed to genetic and modifiable factors. Considerable evidence emerged in modifiable factors and urgently requires standardized evaluation. We conducted an umbrella review to evaluate the strength and validity of the existing evidence. We searched PubMed, Embase, CINAHL and Cochrane Database of Systematic Reviews to identify relevant systematic reviews and meta-analyses of prospective studies regarding the associations of dementia and cognitive impairment with modifiable factors. For each association, we analyzed the summary effect size, 95 % confidence interval, 95 % prediction interval, heterogeneity, small study effect and excess significance bias. Mendelian randomization studies were descriptively reviewed further exploring the causality of the associations. In total, 12,015 articles were identified, of which 118 eligible studies yielded 243 unique associations. Convincing evidence was found for associations of dementia

Environmental and lifestyle risk factors for early-onset dementia: a systematic review.

Bosi M, Malavolti M, Garuti C, Tondelli M, Marchesi C, Vinceti M · Acta bio-medica : Atenei Parmensis · 2022

The term early-onset dementia (EOD) encompasses several forms of neurodegenerative diseases characterized by symptom onset before 65 years and leading to severe impact on subjects already in working activities, as well as on their family and caregivers. Despite the increasing incidence, the etiology is still unknown, with possible association of environmental factors, although the evidence is still scarce. In this review, we aimed to assess how several environmental and lifestyle factors may be associated with the onset of this disease. We conducted a literature search in PubMed and EMBASE databases up to May 6, 2022, to retrieve epidemiological studies evaluating the effect of environmental and lifestyle factors on EOD risk. We eventually included 22 studies, ten with cohort and twelve with case-control design. Traumatic injury, especially on the head/brain, some cardiovascular diseases such as atrial fibrillation and stroke, metabolic diseases including diabetes and hypercholestero

Guidelines on the management of atrial fibrillation

European Society of Cardiology (ESC)

TheseESC clinical practice guidelines offer evidence-based recommendations for the diagnosis and management of atrial fibrillation, covering prevention, stroke risk assessment, and therapeutic interventions. They are developed to assist healthcare professionals in making optimal decisions.

Atrial fibrillation: diagnosis and management

NICE

This guideline covers diagnosing and managing atrial fibrillation (AF) in people aged 18 and over. It aims to improve outcomes by providing recommendations on rate and rhythm control, anticoagulation, and stroke prevention.

Atrial fibrillation: diagnosis and management (CG180)

NICE

This guideline covers diagnosing and managing atrial fibrillation in adults, including recommendations on anticoagulation, rhythm control, and rate control strategies. It aims to improve outcomes and reduce the risk of stroke in people with AF.

Improving outcomes of atrial fibrillation ablation by integrated personalized lifestyle interventions: a randomized controlled trial.

Vermeer J, Vinck-de Greef T, van den Broek M, de Louw B, van Steenbergen G, van Veghel D · European heart journal · 2026 · n=145

Atrial fibrillation (AF) is associated with various lifestyle risk factors. Their presence negatively affects AF catheter ablation outcomes. This study evaluates the efficacy of a nurse-led, integrated lifestyle programme on ablation outcomes. POP-AF is a prospective, randomized, controlled trial involving patients referred for their first AF ablation. Patients were assigned in a 1:1 ratio to standard pre-ablation counselling by the treating electrophysiologist, or a nurse-led integrated lifestyle clinic, including a home sleep apnoea test, weight reduction, alcohol reduction, smoking cessation, and optimal hypertension and hypercholesterolaemia treatment before undergoing pulmonary vein isolation (PVI). The primary endpoint was a composite of hospitalizations for repeat ablations and direct current cardioversions in an event-rate analysis up to 12 months after pulsed-field pulmonary vein isolation. A total of 145 patients participated in the trial; 70 patients were assigned to the c

Catheter Ablation vs Lifestyle Modification With Antiarrhythmic Drugs to Treat Atrial Fibrillation: PRAGUE-25 Trial.

Osmancik P, Roubicek T, Havranek S, Chovancik J, Bulkova V, Herman D · Journal of the American College of Cardiology · 2025 · n=212

Obesity is an important risk factor for atrial fibrillation (AF). Nonrandomized studies have shown that weight loss and increased physical activity are associated with AF reduction. The goal of this study was to assess whether treatment based on lifestyle modification (LFM; directed weight loss and physical exercise) in combination with antiarrhythmic drugs (AADs) is noninferior to catheter ablation (CA) in patients with AF and obesity. In a randomized multicenter noninferiority trial, we enrolled patients with paroxysmal or persistent AF and a body mass index (BMI) of 30-40 kg/m2. Patients were randomized to the CA vs LFM+AAD groups in a 1:1 ratio. Seven-day electrocardiographic Holter recordings were performed every 3 months. The primary endpoint was AF freedom during the 12 months after randomization (ie, absence of any AF episode lasting >30 s; the blanking period was 3 months). Secondary endpoints included AF burden, peak oxygen uptake during cardiopulmonary exercise testing,

n-3 fatty acids and the risk of atrial fibrillation, review.

Herrmann W, Herrmann M · Diagnosis (Berlin, Germany) · 2024

Atrial fibrillation (AF) is the most frequent type of cardiac arrhythmia that affects over six million individuals in Europe. The incidence and prevalence of AF rises with age, and often occurs after cardiac surgery. Other risk factors correlated with AF comprise high blood pressure, diabetes mellitus, left atrial enlargement, ischemic heart disease, and congestive heart failure. Considering the high prevalence of AF in aging societies, strategies to prevent serious complications, such as stroke or heart failure, are important because they are correlated with high morbidity and mortality. The supplementation of sea-derived n-3 polyunsaturated fatty acids (PUFA) is widely discussed in this context, but the results of experimental and observational studies are in contrast to randomized placebo-controlled intervention trials (RCTs). Specifically, larger placebo-controlled n-3 PUFA supplementation studies with long follow-up showed a dose-dependent rise in incident AF. Daily n-3 PUFA doses

Diet and risk of atrial fibrillation: a systematic review.

Gawałko M, Middeldorp ME, Saljic A, Penders J, Jespersen T, Albert CM · European heart journal · 2024

Atrial fibrillation (AF) is the most prevalent sustained cardiac arrhythmia. Comprehensive modification of established AF risk factors combined with dietary interventions and breaking deleterious habits has been shown to reduce AF burden and recurrence. Numerous AF risk factors, such as diabetes, obesity or hypertension can be partially related to dietary and lifestyle choices. Therefore, dietary interventions may have potential as a therapeutic approach in AF. Based on available data, current guidelines recommend alcohol abstinence or reduction to decrease AF symptoms, burden, and progression, and do not indicate the need for caffeine abstention to prevent AF episodes (unless it is a trigger for AF symptoms). Uncertainty persists regarding harms or benefits of other dietary factors including chocolate, fish, salt, polyunsaturated and monounsaturated fatty acids, vitamins, and micronutrients. This article provides a systematic review of the association between AF and both dietary patte

Potassium Supplementation and Prevention of Atrial Fibrillation After Cardiac Surgery: The TIGHT K Randomized Clinical Trial.

O'Brien B, Campbell NG, Allen E, Jamal Z, Sturgess J, Sanders J · JAMA · 2024 · n=1690

Supplementing potassium in an effort to maintain high-normal serum concentrations is a widespread strategy used to prevent atrial fibrillation after cardiac surgery (AFACS), but is not evidence-based, carries risks, and is costly. To determine whether a lower serum potassium concentration trigger for supplementation is noninferior to a high-normal trigger. This open-label, noninferiority, randomized clinical trial was conducted at 23 cardiac surgical centers in the United Kingdom and Germany. Between October 20, 2020, and November 16, 2023, patients with no history of atrial dysrhythmias scheduled for isolated coronary artery bypass grafting (CABG) surgery were enrolled. The last study patient was discharged from the hospital on December 11, 2023. Patients were randomly assigned to a strategy of tight or relaxed potassium control (only supplementing if serum potassium concentration fell below 4.5 mEq/L or 3.6 mEq/L, respectively). Patients wore an ambulatory heart rhythm monitor, wh

The Role of Dietary Magnesium in Cardiovascular Disease.

Nielsen FH · Nutrients · 2024

In the past 20 years, a large number of epidemiological studies, randomized controlled trials, and meta-analyses have found an inverse relationship between magnesium intake or serum magnesium and cardiovascular disease, indicating that low magnesium status is associated with hypertension, coronary artery calcification, stroke, ischemic heart disease, atrial fibrillation, heart failure, and cardiac mortality. Controlled metabolic unit human depletion-repletion experiments found that a mild or moderate magnesium deficiency can cause physiological and metabolic changes that respond to magnesium supplementation, which indicates that these types of deficiencies or chronic latent magnesium deficiency are contributing factors to the occurrence and severity of cardiovascular disease. Mechanisms through which a mild or moderate magnesium deficiency can contribute to this risk include inflammatory stress, oxidative stress, dyslipidemia and deranged lipid metabolism, endothelial dysfunction, and

Atrial fibrillation

NHS

The NHS provides an overview of atrial fibrillation for the general public, detailing symptoms, causes, diagnosis, treatment, and living with the condition in the UK.

What is Atrial Fibrillation (AFib or AF)?

AHA

This page provides an overview of atrial fibrillation, including its causes, symptoms, diagnosis, and treatment options. It serves as a general resource for patients and the public to understand this common heart condition.

Pulse Biosciences' CellFX nsPFA Cardiac Surgery Clamp System for the Treatment of Atrial Fibrillation During Concomitant Cardiac Surgery

n=135 · NCT06959121 · RECRUITING · RECRUITING

The primary objective of this Pivotal study is to demonstrate the safety and effectiveness of the Pulse Biosciences nsPFA™ Cardiac Surgery System in treating atrial fibrillation during concomitant cardiac surgical procedures.

The AMADEUS Trial, A Multicenter, Randomized, Open-label, Assessor Blind, Non-inferiority Study Comparing the Efficacy and Safety of Once-weekly Subcutaneous Idraparinux (SR34006) With Adjusted-dose Oral Vitamin-K Antagonists in the Prevention of Thromboembolic Events in Patients With Atrial Fibrillation

n=4673 · NCT00070655 · COMPLETED · COMPLETED

This trial will include patients who have a heart condition called atrial fibrillation. Atrial fibrillation is an abnormal rhythm (irregular beat) in the heart. Patients with atrial fibrillation have an increased chance for a blood clot to form in the heart and move to other blood vessels in the body and cause obstruction. This obstruction may damage tissue. For example, a blood clot plugging a vessel in the brain could cause a stroke. Therefore, patients with atrial fibrillation may be given anticoagulant (blood-thinning) tablets such as warfarin or acenocoumarol. The purpose of this study is to compare the safety and effectiveness of a new injectable anticoagulant drug that is administered once weekly, SR34006 with warfarin or acenocoumarol tablets. Assignment to either SR34006 Injection or vitamin K antagonist (warfarin or acenocoumarol) tablets will be purely by chance and will be known by both patients and their doctors.

A Randomised Controlled Trial to Compare Manual Compression and Suture-mediated Haemostasis After Catheter Ablation of Atrial Fibrillation

n=336 · NCT06470555 · COMPLETED · COMPLETED

Atrial fibrillation (AF) is the most common heart rhythm disorder affecting adults in the United Kingdom. In patients with AF who continue to experience symptoms despite medications, catheter ablation is an established interventional treatment. Ablation is performed by inserting a number of plastic tubes in the veins in the groin, in order to access the heart. Despite continued advances in equipment and techniques, groin complications remain the most common complications after AF ablation. The severity of these can range from minor (e.g. bleeding resolvable with manual pressure) to major (bleeding requiring blood transfusion, prolonged hospitalisation, intervention, or rarely resulting in death). Following ablation, the plastic tubes in the groin are removed before leaving the procedure room. Once removed, the doctor will stop the bleeding in the groin. There are two commons ways in which the doctor can stop the bleeding: 1) conventional treatment with manual compression - the doctor applies pressure with their hands to the groin area to stop the bleeding; 2) suture treatment (also known as a "stitch") - the doctor inserts a suture to the groin area and secures this in place with a small plastic device (called a three-way tap). The suture and three-way tap are left in place for a few hours before being removed. Both of these methods are commonly in use. However, there is no high-quality evidence to support whether one way is better than the other. After stopping the bleeding, patients are generally asked to lay flat for 4 hours to prevent any bleeding. It is not known whether this duration can safely be shortened. The Haemostasis AfteR veNous accESS in AF catheter ablation (HARNESS) trial is a pragmatic, single-centre, open label, randomised controlled trial which will compare a suture with a three-way tap to manual compression, and examine the impact of bed rest duration on clinical outcomes.

Cochrane Library: Atrial Fibrillation

Cochrane

The Cochrane Library provides systematic reviews and meta-analyses on various interventions for atrial fibrillation, offering high-quality evidence to inform healthcare decisions. This aggregator is a crucial resource for evidence-based medicine.

Clinical search for Atrial Fibrillation

TRIP Database

TRIP Database is an evidence-based search engine that allows users to quickly find high-quality research evidence, clinical guidelines, and systematic reviews related to atrial fibrillation. It aggregates evidence from various sources.

TRIP Database: Atrial Fibrillation

TRIP Database

TRIP is a clinical search engine designed to allow users to quickly find high-quality research evidence to support their practice, including numerous resources on atrial fibrillation.