Risk Factor Management in Atrial Fibrillation: How to Deliver a Successful Clinic

Purpose of Review: To summarize the evidence underpinning the role of risk factor management in atrial fibrillation (AF) and to describe the key components critical to the successful delivery of this aspect of AF care. Recent Findings: Recent studies exploring the role of risk factor management in AF have demonstrated the importance of comprehensively and simultaneously managing all risk factors. Strong evidence exists to support the aggressive management of overweight and obesity, hypertension, diabetes, obstructive sleep apnea, alcohol excess, and physical inactivity in improving outcomes in this population. Other factors, such as dyslipidemia, are managed according to individual cardiovascular risk. The use of protocol-driven care, assisted by a checklist, is critical to ensure that all risk factors are comprehensively addressed in a standardized fashion. Engaging the patient through the health behavior change process, by assessing importance and confidence in achieving the desired change and goal setting to achieve targets, increases the likelihood of success. Regular reviews and feedback are essential to ensure accountability and ongoing engagement. Summary: Risk factor management is an essential pillar of AF care that should be incorporated alongside appropriate use of oral anticoagulation, rate control, and rhythm management. Successful implementation of this aspect of comprehensive AF management requires a protocol-driven approach with regular follow-up to maximize patient engagement.