Identify unhealthy lifestyle factors and give the patient advice on these to help prevent recurrence.[1]Hindricks G, Potpara T, Dagres N, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021 Feb 1;42(5):373-498.
https://academic.oup.com/eurheartj/article/42/5/373/5899003
http://www.ncbi.nlm.nih.gov/pubmed/32860505?tool=bestpractice.com
Focus, where relevant, on the following factors.
Physical activity: encourage the patient to undertake moderate-intensity exercise and remain physically active.[1]Hindricks G, Potpara T, Dagres N, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021 Feb 1;42(5):373-498.
https://academic.oup.com/eurheartj/article/42/5/373/5899003
http://www.ncbi.nlm.nih.gov/pubmed/32860505?tool=bestpractice.com
Advise the patient to avoid excessive endurance exercise (e.g., marathons and long-distance triathlons), especially if they are over 50 years old.[1]Hindricks G, Potpara T, Dagres N, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021 Feb 1;42(5):373-498.
https://academic.oup.com/eurheartj/article/42/5/373/5899003
http://www.ncbi.nlm.nih.gov/pubmed/32860505?tool=bestpractice.com
Weight loss with comprehensive management of concomitant cardiovascular risk factors: maintaining a healthy weight may reduce blood pressure, dyslipidaemia, and risk of developing type 2 diabetes mellitus, therefore improving the patient’s overall cardiovascular risk profile.[1]Hindricks G, Potpara T, Dagres N, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021 Feb 1;42(5):373-498.
https://academic.oup.com/eurheartj/article/42/5/373/5899003
http://www.ncbi.nlm.nih.gov/pubmed/32860505?tool=bestpractice.com
Alcohol intake reduction: regular heavier alcohol consumption (>14 units/week) is associated with an increased risk of AF.[23]Gémes K, Malmo V, Laugsand LE, et al. Does moderate drinking increase the risk of atrial fibrillation? The Norwegian HUNT (Nord-Trøndelag health) study. J Am Heart Assoc. 2017 Oct 20;6(10):e007094.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5721892
http://www.ncbi.nlm.nih.gov/pubmed/29054845?tool=bestpractice.com
Alcohol abstinence has been shown to reduce arrhythmia recurrence in regular drinkers with AF.[1]Hindricks G, Potpara T, Dagres N, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021 Feb 1;42(5):373-498.
https://academic.oup.com/eurheartj/article/42/5/373/5899003
http://www.ncbi.nlm.nih.gov/pubmed/32860505?tool=bestpractice.com
Work with the patient to identify strategies for comprehensive risk-factor modification and interventions targeting underlying conditions that may apply, in particular:[1]Hindricks G, Potpara T, Dagres N, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021 Feb 1;42(5):373-498.
https://academic.oup.com/eurheartj/article/42/5/373/5899003
http://www.ncbi.nlm.nih.gov/pubmed/32860505?tool=bestpractice.com
Hypertension
Heart failure
Coronary artery disease
Diabetes mellitus
Obstructive sleep apnoea