Atrial Fibrillation: More Than an Electrical Problem

We often divide up the different types of cardiac disease into 3 distinct systems: (1) the “plumbing” (coronary artery disease [CAD]); (2) the “electricity”; and (3) the “pump.” However, we are now are beginning to appreciate that the risk factors that affect these systems and underlie heart disease are more closely interrelated than was previously thought. Atrial fibrillation (AF), which was traditionally placed into the “electricity” category, has now shown a clear relationship to risk factors for “plumbing” diseases, such as hypertension, hyperlipidemia, diabetes, and obesity. Results of the Aggressive Risk Factor Reduction Study for Atrial Fibrillation and Implications for the Outcome of Ablation: The ARREST-AF Cohort Study from Australia, published in the Journal of the American College of Cardiology in December 2014, demonstrate the potential for more successful outcomes when we can "blur the lines" among traditional categories.