Importance

It has been suggested that atrial fibrillation (AF) is the new cardiovascular disease epidemic of the 21st century. Clinical cardiology has largely focused on AF treatment and associated stroke prevention rather than preventing AF itself. To reduce the global consequences and associated costs of AF, it is critical to now embrace prevention as a priority. Proactively addressing the risk factors for AF and the underlying unhealthy lifestyle habits that contribute to them, using research-based counseling approaches, represents a complementary and adjunctive alternative in combatting this disease burden.

Observations

Encouraging and sustaining patient involvement to reduce AF incidence and improve outcomes begins with screening to identify risk factors, unhealthy lifestyle habits, and characteristics associated with failed attempts at favorably modifying these causalities. Modulators of and common barriers to achieving risk reduction and lifestyle change include self-efficacy, social support, age, sex, marital and socioeconomic status, education, employment, and psychosocial factors such as depression, isolation, anxiety and chronic life stress. Focused behavioral counseling approaches, including assessing the patient's readiness to change, motivational interviewing and using the 5 A's (assess, advise, agree, assist, arrange), along with employing initial downscaled goals to overcome inertia, are proven methodologies to overcome these common barriers to favorably modifying risk factors and unhealthy lifestyle habits.

Conclusions and relevance

To complement and enhance the current armamentarium for the medical management of cardiac arrhythmias, there is an urgent need to proactively address the causative factors triggering new-onset, recurrent and persistent AF. Beyond the counseling skills of highly trained professionals (eg, psychiatrists, psychologists), this narrative review highlights the need for and potential impact on lifestyle modification that non-behavioral scientists, including internal medicine, cardiology, and allied health professionals, can have on the patients they serve.

中文翻译：

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除了心脏复律、消融和药物治疗：预防和治疗房颤的危险因素、生活方式改变和行为咨询策略

重要性

有人提出心房颤动 (AF) 是 21 世纪新的心血管疾病流行病。临床心脏病学主要关注 AF 治疗和相关的卒中预防，而不是预防 AF 本身。为了减少 AF 的全球后果和相关成本，现在将预防作为优先事项至关重要。使用基于研究的咨询方法主动解决 AF 的风险因素和导致这些因素的潜在不健康生活方式，代表了对抗这种疾病负担的补充和辅助替代方案。

观察

鼓励和维持患者参与以降低 AF 发生率和改善结果，首先要进行筛查以识别风险因素、不健康的生活习惯以及与改善这些因果关系的失败尝试相关的特征。降低风险和改变生活方式的调节因素和常见障碍包括自我效能、社会支持、年龄、性别、婚姻和社会经济状况、教育、就业和心理社会因素，如抑郁、孤立、焦虑和慢性生活压力。重点行为咨询方法，包括评估患者对改变的准备情况、动机访谈和使用 5 A（评估、建议、同意、协助、安排），以及采用初始缩小目标来克服惯性，

结论和相关性

为了补充和增强当前的心律失常医疗管理设备，迫切需要主动解决引发新发、复发和持续性 AF 的诱因。除了训练有素的专业人员（例如精神病学家、心理学家）的咨询技能之外，这篇叙述性评论强调了非行为科学家（包括内科、心脏病学和专职卫生专业人员）对生活方式改变的必要性和潜在影响。他们服务的患者。