RISK
FACTORS
Atrial Fibrillation
AF progresses...
even without AF.
The role of
'Second Factor'.
AF progresses even without AF.
The role of 'Second Factor'.
Characters of the Second Factors
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Atrial Fibrosis
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Atrial conduction delay and atrial voltage reduction
Atria Remodelling as Consequences of Sustained Obesity (1/2)
20 sheeps
|
→
Induced obesity over 36wks
|
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Maintained obesity over another 36wks.
Mean weight 110kgs. |
→
Maintained normal weight.
|
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Mean weight 60 kgs. |
Atria Remodelling as Consequences of Sustained Obesity (2/2)
More fibrosis in obesed sheeps than that of control (8% vs 5%).
Obesity and
the substrate for AF.
Risk Factors and Mechanism of AF
AF & CV
RISKS
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Meta-analysis of 9.6 millions participants showed the association of AF and poor outcomes.
AF & Stroke: A risk factor or risk marker?
- Stroke may occur even without AF being present.
In a substudy from ASSERT,
AF was detected before stroke or SE only in 35%.
(Circulation 2014.)
- AF patients died of non-stroke related death much more than stroke related death.
In GARFIELD-AF,
the most frequent 2-yr major outcomes of patients with new AF was death; less than 10%
were stroke related.
(Eur Heart J 2016.)
Worse outcomes in permanent and persistent than in paroxysmal AF.
Treating HTN and HF to prevent AF.
RISK
FACTORS Management and Goals
integrated
CARE
for Atrial Fibrillation