La modificación de los factores de riesgo y del estilo de vida es clave en el éxito a largo plazo de la cardioversión en la FA y en la prevención de su recurrencia.[48]Chyou JY, Barkoudah E, Dukes JW, et al. Atrial fibrillation occurring during acute hospitalization: a scientific statement from the American Heart Association. Circulation. 2023 Apr 11;147(15):e676-98.
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001133
http://www.ncbi.nlm.nih.gov/pubmed/36912134?tool=bestpractice.com
[52]Powell-Wiley TM, Poirier P, Burke LE, et al. Obesity and cardiovascular disease: A scientific statement from the American Heart Association. Circulation. 2021 May 25;143(21):e984-1010.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8493650
http://www.ncbi.nlm.nih.gov/pubmed/33882682?tool=bestpractice.com
[78]Wingerter R, Steiger N, Burrows A, et al. Impact of Lifestyle Modification on Atrial Fibrillation. Am J Cardiol. 2020 Jan 15;125(2):289-97.
http://www.ncbi.nlm.nih.gov/pubmed/31761147?tool=bestpractice.com
Se ha comprobado que la pérdida de peso hasta alcanzar un índice de masa corporal normal, junto con un tratamiento intensivo de los factores de riesgo, reduce la carga y la gravedad de los síntomas de la fibrilación auricular, y da como resultado una remodelación cardíaca beneficiosa.[48]Chyou JY, Barkoudah E, Dukes JW, et al. Atrial fibrillation occurring during acute hospitalization: a scientific statement from the American Heart Association. Circulation. 2023 Apr 11;147(15):e676-98.
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001133
http://www.ncbi.nlm.nih.gov/pubmed/36912134?tool=bestpractice.com
[52]Powell-Wiley TM, Poirier P, Burke LE, et al. Obesity and cardiovascular disease: A scientific statement from the American Heart Association. Circulation. 2021 May 25;143(21):e984-1010.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8493650
http://www.ncbi.nlm.nih.gov/pubmed/33882682?tool=bestpractice.com
[162]Voskoboinik A, Kalman JM, De Silva A, et al. Alcohol Abstinence in Drinkers with Atrial Fibrillation. N Engl J Med. 2020 Jan 2;382(1):20-28.
https://www.doi.org/10.1056/NEJMoa1817591
http://www.ncbi.nlm.nih.gov/pubmed/31893513?tool=bestpractice.com
[168]Abed HS, Wittert GA, Leong DP, et al. Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: a randomized clinical trial. JAMA. 2013;310:2050-2060.
http://jama.jamanetwork.com/article.aspx?articleid=1779533
http://www.ncbi.nlm.nih.gov/pubmed/24240932?tool=bestpractice.com
[169]Abdul-Aziz AA, Altawil M, Lyon A, et al. Lifestyle Therapy for the Management of Atrial Fibrillation. Am J Cardiol. 2018 May 1;121(9):1112-1117.
http://www.ncbi.nlm.nih.gov/pubmed/29650239?tool=bestpractice.com
En pacientes con factores de riesgo cardiovascular, el tratamiento con estatinas puede proteger frente a la fibrilación auricular recurrente.[52]Powell-Wiley TM, Poirier P, Burke LE, et al. Obesity and cardiovascular disease: A scientific statement from the American Heart Association. Circulation. 2021 May 25;143(21):e984-1010.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8493650
http://www.ncbi.nlm.nih.gov/pubmed/33882682?tool=bestpractice.com
La abstinencia del alcohol puede aumentar el éxito en el mantenimiendo del ritmo sinusal después de la ablación o durante el tratamiento con fármacos antiarrítmicos.[52]Powell-Wiley TM, Poirier P, Burke LE, et al. Obesity and cardiovascular disease: A scientific statement from the American Heart Association. Circulation. 2021 May 25;143(21):e984-1010.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8493650
http://www.ncbi.nlm.nih.gov/pubmed/33882682?tool=bestpractice.com
[78]Wingerter R, Steiger N, Burrows A, et al. Impact of Lifestyle Modification on Atrial Fibrillation. Am J Cardiol. 2020 Jan 15;125(2):289-97.
http://www.ncbi.nlm.nih.gov/pubmed/31761147?tool=bestpractice.com
[162]Voskoboinik A, Kalman JM, De Silva A, et al. Alcohol Abstinence in Drinkers with Atrial Fibrillation. N Engl J Med. 2020 Jan 2;382(1):20-28.
https://www.doi.org/10.1056/NEJMoa1817591
http://www.ncbi.nlm.nih.gov/pubmed/31893513?tool=bestpractice.com
El uso adecuado de la presión positiva continua en las vías respiratorias en pacientes con apnea obstructiva del sueño también puede ayudar a mantener el ritmo sinusal tras el tratamiento de la FA.[48]Chyou JY, Barkoudah E, Dukes JW, et al. Atrial fibrillation occurring during acute hospitalization: a scientific statement from the American Heart Association. Circulation. 2023 Apr 11;147(15):e676-98.
https://www.ahajournals.org/doi/10.1161/CIR.0000000000001133
http://www.ncbi.nlm.nih.gov/pubmed/36912134?tool=bestpractice.com
[52]Powell-Wiley TM, Poirier P, Burke LE, et al. Obesity and cardiovascular disease: A scientific statement from the American Heart Association. Circulation. 2021 May 25;143(21):e984-1010.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8493650
http://www.ncbi.nlm.nih.gov/pubmed/33882682?tool=bestpractice.com
[78]Wingerter R, Steiger N, Burrows A, et al. Impact of Lifestyle Modification on Atrial Fibrillation. Am J Cardiol. 2020 Jan 15;125(2):289-97.
http://www.ncbi.nlm.nih.gov/pubmed/31761147?tool=bestpractice.com
Los inhibidores de la ECA y los antagonistas de los receptores de la angiotensina II pueden ser útiles para la prevención primaria y secundaria de la FA en pacientes con insuficiencia cardíaca.[170]Yu Z, Zhang D, Ji Q, et al. Inhibition of the renin-angiotensin-aldosterone system prevents and cures atrial fibrillation: An overview of systematic reviews. Medicine (Baltimore). 2021 May 7;100(18):e25559.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8104282
http://www.ncbi.nlm.nih.gov/pubmed/33950930?tool=bestpractice.com