From the Guidelines
Atrial fibrillation is primarily caused by a combination of structural heart abnormalities and electrical disturbances, with common causes including high blood pressure, coronary artery disease, heart valve problems, heart failure, and previous heart attacks, as well as age, thyroid disorders, excessive alcohol consumption, sleep apnea, obesity, diabetes, chronic lung diseases, and certain medications, as supported by the most recent study 1.
Causes of Atrial Fibrillation
The causes of atrial fibrillation can be divided into several categories, including:
- Structural heart abnormalities, such as high blood pressure, coronary artery disease, heart valve problems, and heart failure
- Electrical disturbances, such as abnormal electrical signals that override the heart's natural pacemaker
- Age, with atrial fibrillation becoming more common after age 65 due to natural heart changes
- Thyroid disorders, particularly hyperthyroidism
- Excessive alcohol consumption, especially binge drinking
- Sleep apnea
- Obesity
- Diabetes
- Chronic lung diseases
- Certain medications, as noted in the study on drug-induced atrial fibrillation 1
Risk Factors
Several risk factors contribute to the development of atrial fibrillation, including:
- High blood pressure
- Coronary artery disease
- Heart valve problems
- Heart failure
- Previous heart attacks
- Age
- Thyroid disorders
- Excessive alcohol consumption
- Sleep apnea
- Obesity
- Diabetes
- Chronic lung diseases
- Certain medications As stated in the study 1, multiple clinical risk factors, electrocardiographic and echocardiographic features, and biochemical markers are associated with an increased risk of atrial fibrillation.
Mechanism
The fundamental mechanism of atrial fibrillation involves abnormal electrical signals that override the heart's natural pacemaker, causing the atria to quiver rather than contract effectively, which can lead to blood clots, stroke, and heart failure if left untreated, as explained in the expert consensus document 1.
Personalized Prevention and Treatment
A personalized approach to prevention and treatment of atrial fibrillation is necessary, taking into account the individual's specific risk factors and health modifiers, such as atrial fibrosis and ageing, altered calcium homeostasis, ion-channel dysfunction, and genetic susceptibility, as proposed in the expert consensus document 1.
From the Research
Causes of Atrial Fibrillation
The causes of atrial fibrillation (AF) are complex and multifaceted. Several studies have investigated the relationship between AF and other cardiovascular diseases, as well as the underlying risk factors and mechanisms. Some of the key findings include:
- Coronary heart disease (CHD) and AF are closely linked, with a strong correlation between the two diseases 2, 3.
- CHD can promote the progression of AF by affecting reentry formation, focal ectopic activity, and neural remodeling 2.
- AF can also affect CHD by promoting atherosclerosis, mismatch of blood supply and oxygen consumption, and thrombosis 2, 3.
- Hypertension is a major risk factor for AF, with high blood pressure increasing the risk of AF and accounting for more cases of AF than other risk factors 4, 5, 6.
- The relationship between AF and coronary artery disease (CAD) is complex, with the two diseases sharing common risk factors and pathophysiology 3.
- Inflammation and endothelial dysfunction are central to both AF and CAD, and may be a therapeutic target in the management of these diseases 3.
- High blood pressure is associated with the strongest evidence for causation of cardiovascular disease, including AF, and has a high prevalence of exposure 6.
Risk Factors
Some of the key risk factors for AF include:
Mechanisms
The mechanisms underlying AF are complex and not fully understood. However, some of the key mechanisms include: