Prevention of Atrial Fibrillation

Prevention of atrial fibrillation (AF) consists of targeted treatment of comorbidities and modification of risk factors that contribute to the development (incidence) of AF. The goal of prevention is to prevent the onset of AF.

Basic principles of AF prevention:

Adequate treatment of comorbidities:

Arterial hypertension
Diabetes mellitus
Heart failure
Obesity
Sleep apnoea syndrome
Dyslipidaemia

Modification and elimination of risk factors:

Limitation of alcohol intake
No smoking
Regular physical activity
Body weight control (BMI ~ 27 kg/m₂).

Illustration depicting prevention of atrial fibrillation through a healthy lifestyle, including regular physical activity and a balanced diet.

Prevention of Atrial Fibrillation	Class
Adequate treatment of arterial hypertension (<140/90 mmHg) reduces the incidence of AF. Preferred agents are ACE inhibitors or angiotensin receptor blockers.	I
Adequate treatment of heart failure (HF) reduces the incidence of AF. In all patients with HF, SGLT2 inhibitors and diuretics (if signs of congestion are present) are recommended.	I
Maintaining BMI <27 kg/m² reduces the incidence of AF.	I
Regular moderate aerobic activity (brisk walking, cycling, running) at least 5 times per week for 30 minutes reduces the incidence of AF.	I
The maximum alcohol intake that does not increase the incidence of AF is up to 3 standard drinks per 7 days. A standard drink is defined as: 0.3 L of beer, or 1 dL of wine, or 40 mL of vodka (or another 40% alcoholic beverage).	I
Binge drinking (alcohol excess) is not recommended because it increases the incidence of AF.	III
Adequate glycaemic control in patients with diabetes mellitus reduces the incidence of AF. Preferred treatment includes SGLT2 inhibitors or metformin.	I
Smoking is not recommended because it increases the incidence of AF.	III