Modern guidelines for the management of patients with atrial fibrillation and comorbid conditions: a literature review

Authors

DOI:

https://doi.org/10.14739/2310-1210.2025.6.336900

Keywords:

atrial fibrillation, comorbid conditions, arterial hypertension, type 2 diabetes mellitus, obesity, heart failure, coronary artery disease, chronic kidney disease, obstructive sleep apnea, diagnosis, treatment

Abstract

Aim. To summarize and analyze current literature data on the management of patients with atrial fibrillation (AF) and comorbid conditions.

Materials and methods. A systematic analysis of scientific publications from databases including PubMed, Scopus, Web of Science, and Google Scholar was conducted for the period 2020–2025. Additionally, the latest clinical guidelines from the ESC (2024), AHA / ACC / HRS (2023), and Ukrainian national recommendations were reviewed. The selected sources focused on the diagnosis, treatment, and prevention of AF in patients with comorbid diseases. Only publications meeting the criteria of thematic relevance, full-text availability, and up-to-date clinical content were included.

Results. In most clinical cases, AF is a manifestation of a polymorbid condition, which significantly modifies its clinical course, increases the risk of complications, and reduces the effectiveness of both pharmacological and interventional therapies. Comorbidities such as arterial hypertension, coronary artery disease, heart failure, type 2 diabetes mellitus, chronic kidney disease, obesity, and obstructive sleep apnea are considered not only etiological factors of AF but also markers of overall cardiovascular risk and/or structural heart disease. Timely diagnosis of AF considering comorbid pathology and based on electrocardiographic, imaging, and clinical-laboratory parameters, combined with risk stratification using validated scales (CHA2DS2-VA, HAS-BLED, mEHRA, SAMe-TT2R2, etc.) is crucial for selecting an optimal therapeutic strategy and reducing complication rates. The 2024 ESC guidelines propose an integrated AF-CARE pathway for AF management, which includes not only rhythm control and anticoagulation therapy but also mandatory management of comorbid conditions, thus forming the foundation for preventing AF recurrence and progression.

Conclusions. Comorbid conditions significantly influence the prognosis of AF patients, the choice of treatment strategy, and its effectiveness. Early diagnosis, risk stratification, and targeted management of comorbidities, based on the AF-CARE approach, should be considered an integral part of comprehensive AF care, contributing to improved clinical outcomes, patient survival, and quality of life.

Author Biographies

N. S. Mykhailovska, Zaporizhzhia State Medical and Pharmaceutical University

MD, PhD, DSc, Professor, Head of the Department of General Practice – Family Medicine and Internal Medicine

R. V. Lytvynenko, Zaporizhzhia State Medical and Pharmaceutical University

MD, PhD student of the Department of General Practice – Family Medicine and Internal Medicine

Ya. M. Mykhailovskyi, Zaporizhzhia State Medical and Pharmaceutical University

MD, PhD, Assistant of the Department of Therapy, Cardiology, Educational and Scientific Institute of Postgraduate Education

O. V. Shershnyova, Zaporizhzhia State Medical and Pharmaceutical University

MD, PhD, Associate Professor of the Department of General Practice – Family Medicine and Internal Medicine

References

  1. Lippi G, Sanchis-Gomar F, Cervellin G. Global epidemiology of atrial fibrillation: An increasing epidemic and public health challenge. Int J Stroke. 2021;16(2):217-21. doi: https://doi.org/10.1177/1747493019897870. Erratum in: Int J Stroke. 2020;15(9):NP11-NP12. doi: https://doi.org/10.1177/1747493020905964
  2. Salih M, Abdel-Hafez O, Ibrahim R, Nair R. Atrial fibrillation in the elderly population: Challenges and management considerations. J Arrhythm. 2021;37(4):912-21. doi: https://doi.org/10.1002/joa3.12580
  3. Cintra FD, Figueiredo MJ. Atrial Fibrillation (Part 1): Pathophysiology, Risk Factors, and Therapeutic Basis. Arq Bras Cardiol. 2021;116(1):129-39. English, Portuguese. doi: https://doi.org/10.36660/abc.20200485
  4. Tomaiko-Clark E, Husain F, Su W. Weight loss and atrial fibrillation: a review. Curr Opin Cardiol. 2023;38(1):6-10. doi: https://doi.org/10.1097/HCO.0000000000001004
  5. Akhtar KH, Jafry AH, Beard C, Nasir YM, Agarwal S, Khan J, et al. The effect of weight loss on recurrence of atrial fibrillation after catheter ablation: A systematic review and meta-analysis. J Cardiovasc Electrophysiol. 2023;34(12):2514-26. doi: https://doi.org/10.1111/jce.16090
  6. Ahammed MR, Ananya FN. Impact of weight loss on atrial fibrillation. Cureus. 2023;15(9):e46232. doi: https://doi.org/10.7759/cureus.46232
  7. Antoun I, Layton GR, Nizam A, Barker J, Abdelrazik A, Eldesouky M, et al. Hypertension and atrial fibrillation: bridging the gap between mechanisms, risk, and therapy. Medicina (Kaunas). 2025;61(2):362. doi: https://doi.org/10.3390/medicina61020362
  8. Koniari I, Bozika M, Nastouli K-M, Tzegka D, Apostolos A, Velissaris D, et al. The role of early risk factor modification and ablation in atrial fibrillation substrate remodeling prevention. Biomedicines. 2025;13(2):405. doi: https://doi.org/10.3390/biomedicines13020405
  9. Brilliant J, Yadav R, Akhtar T, Calkins H, Trayanova N, Spragg D, et al. Clinical and structural factors affecting ablation outcomes in atrial fibrillation patients – a review. Curr Cardiol Rev. 2023;19(5):83-96. doi: https://doi.org/10.2174/1573403X19666230331103153
  10. Reddy YN, Borlaug BA, Gersh BJ. Management of atrial fibrillation across the spectrum of heart failure with preserved and reduced ejection fraction. Circulation. 2022;146(4):339-57. doi: https://doi.org/10.1161/CIRCULATIONAHA.122.057444
  11. Joglar JA, Chung MK, Armbruster AL, Benjamin EJ, Chyou JY, Cronin EM, et al. 2023 ACC/AHA/ACCP/HRS guideline for the diagnosis and management of atrial fibrillation: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2024;149(1):e1-e156. doi: https://doi.org/10.1161/CIR.0000000000001193
  12. Martínez-Montesinos L, Rivera-Caravaca JM, Agewall S, Soler-Espejo E, Lip GY, Marín F, et al. Polypharmacy and adverse events in atrial fibrillation: main cause or reflection of multimorbidity? Biomed Pharmacother. 2022;158:114064. doi: https://doi.org/10.1016/j.biopha.2022.114064
  13. Heijman J, Linz D, Schotten U. Dynamics of atrial fibrillation mechanisms and comorbidities. Annu Rev Physiol. 2021;83:83-106. doi: https://doi.org/10.1146/annurev-physiol-031720-085307
  14. Čarná Z, Osmančík P. The effect of obesity, hypertension, diabetes mellitus, obstructive sleep apnea, and alcohol consumption on the risk of atrial fibrillation. Physiol Res. 2021;70(Suppl 4):S511-S525. doi: https://doi.org/10.33549/physiolres.934744
  15. Pelliccia A, Sharma S, Gati S, Bäck M, Börjesson M, Caselli S, et al. 2020 ESC guidelines on sports cardiology and exercise in patients with cardiovascular disease. Eur Heart J. 2021;42(1):17-96. doi: https://doi.org/10.1093/eurheartj/ehaa605
  16. Van Gelder IC, Rienstra M, Bunting KV, Casado Arroyo R, Caso V, Crijns HJ, et al. 2024 ESC guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2024;45(36):3314-414. doi: https://doi.org/10.1093/eurheartj/ehae176
  17. Fredriksson T, Kemp Gudmundsdottir K, Frykman V, Friberg L, Al Khalili F, Engdahl J, et al. Brief episodes of rapid irregular atrial activity (micro AF) are a risk marker for atrial fibrillation: a prospective cohort study. BMC Cardiovasc Disord. 2020;20(1):167. doi: https://doi.org/10.1186/s12872-020-01453-w
  18. Berge T, Myhre PL, Kalstad AA, Laake K, Tveit SH, Onarheim S, et al. Screen-Detected Atrial Fibrillation and "Micro-Atrial Fibrillation" and Risk of Cardiovascular Events after Myocardial Infarction in Elderly Patients. Cardiology. 2023;148(1):72-7. doi: https://doi.org/10.1159/000528726
  19. Hygrell T. Implications of brief episodes of atrial fibrillation (micro AF) [dissertation]. Stockholm: Karolinska Institutet; 2024. Available from: https://hdl.handle.net/10616/47111
  20. Benezet-Mazuecos J, Rosado AL, Crosa J, Iglesias JA. Atrial high-rate episodes, subclinical atrial fibrillation and short-term stroke risk: what is evidence and what is interpretation? J Saudi Heart Assoc. 2020;32(2):295-7. doi: https://doi.org/10.37616/2212-5043.1119
  21. Jiang H, Tan SY, Wang JK, Li J, Tu TM, Tan VH, Yeo C. A meta-analysis of extended ECG monitoring in detection of atrial fibrillation in patients with cryptogenic stroke. Open Heart. 2022;9(2):e002081. doi: https://doi.org/10.1136/openhrt-2022-002081
  22. Healey JS, Lopes RD, Granger CB, Alings M, Rivard L, McIntyre WF, et al. Apixaban for stroke prevention in subclinical atrial fibrillation. N Engl J Med. 2023;390(2):107-17. doi: https://doi.org/10.1056/NEJMoa2310234
  23. Kashou AH, Adedinsewo DA, Noseworthy PA. Subclinical atrial fibrillation: a silent threat with uncertain implications. Annu Rev Med. 2022;73:355-62. doi: https://doi.org/10.1146/annurev-med-042420-105906
  24. Silajdzija E, Lund IM, Bech Jensen J, Sheikh AP, Hansen JL, Tourkaman M, et al. Screening of diabetic and heart failure patients for silent atrial fibrillation. CJC Open. 2024;7(3):262-9. doi: https://doi.org/10.1016/j.cjco.2024.11.023
  25. Pamporis K, Karakasis P, Sagris M, Theofilis P, Milaras N, Pantelidaki A, et al. Prevalence of asymptomatic atrial fibrillation and risk factors associated with asymptomatic status: a systematic review and meta-analysis. Eur J Prev Cardiol. 2025;zwaf138. doi: https://doi.org/10.1093/eurjpc/zwaf138
  26. Steinhubl SR, Waalen J, Sanyal A, Edwards AM, Ariniello LM, Ebner GS, et al. Three year clinical outcomes in a nationwide, observational, siteless clinical trial of atrial fibrillation screening-mHealth Screening to Prevent Strokes (mSToPS). PLoS One. 2021;16(10):e0258276. doi: https://doi.org/10.1371/journal.pone.0258276
  27. Lubitz SA, Faranesh AZ, Selvaggi C, Atlas SJ, McManus DD, Singer DE, et al. Detection of atrial fibrillation in a large population using wearable devices: the Fitbit Heart Study. Circulation. 2022;146(19):1415-24. doi: https://doi.org/10.1161/CIRCULATIONAHA.122.060291
  28. Chen W, Khurshid S, Singer DE, Atlas SJ, Ashburner JM, Ellinor PT, et al. Cost-effectiveness of screening for atrial fibrillation using wearable devices. JAMA Health Forum. 2022;3(8):e222419. doi: https://doi.org/10.1001/jamahealthforum.2022.2419
  29. Charlton PH, Kyriacou PA, Mant J, Marozas V, Chowienczyk P, Alastruey J, et al. Wearable photoplethysmography for cardiovascular monitoring. Proc IEEE. 2022;110(3):355-81. doi: https://doi.org/10.1109/JPROC.2022.3149785
  30. Iqhrammullah M, Abdullah A, Hermansyah, Ichwansyah F, Rani HA, Alina M, et al. Accuracy and interpretability of smartwatch electrocardiogram for early detection of atrial fibrillation: a systematic review and meta-analysis. J Arrhythm. 2025;41(3):e70087. doi: https://doi.org/10.1002/joa3.70087
  31. Karakasis P, Theofilis P, Sagris M, Pamporis K, Stachteas P, Sidiropoulos G, et al. Artificial intelligence in atrial fibrillation: from early detection to precision therapy. J Clin Med. 2025;14(8):2627. doi: https://doi.org/10.3390/jcm14082627
  32. Papalamprakopoulou Z, Stavropoulos D, Moustakidis S, Avgerinos D, Efremidis M, Kampaktsis PN, et al. Artificial intelligence enabled atrial fibrillation detection using smartwatches: current status and future perspectives. Front Cardiovasc Med. 2024;11:1432876. doi: https://doi.org/10.3389/fcvm.2024.1432876
  33. Qiu D, Peng L, Ghista DN, Wong KK. Left atrial remodeling mechanisms associated with atrial fibrillation. Cardiovasc Eng Technol. 2021;12(3):361-72. doi: https://doi.org/10.1007/s13239-021-00527-w
  34. Pérez-Riera AR, Barbosa-Barros R, Pereira-Rejálaga LE, Nikus K, Shenasa M. Electrocardiographic and echocardiographic abnormalities in patients with risk factors for atrial fibrillation. Card Electrophysiol Clin. 2021;13(1):211-9. doi: https://doi.org/10.1016/j.ccep.2020.10.002
  35. Maslova V, Demming T, Pantlik R, Geczy T, Falk P, Remppis BA, et al. Omitting transesophageal echocardiography before catheter ablation of atrial fibrillation: individualized selective approach shows low thromboembolic risk. J Interv Card Electrophysiol. 2024;67(8):1781-91. doi: https://doi.org/10.1007/s10840-024-01825-8
  36. Mehnroush Toufan Tabrizi, Girardo M, Naqvi TZ. In situ transesophageal echocardiography during electrical cardioversion in patients with atrial fibrillation–safety and echocardiographic findings. J Am Soc Echocardiogr. 2024;37(4):420-7. doi: 10.1016/j.echo.2023.11.022
  37. Hadari A, Nguadi J, Jalal H, Bendriss L. Enhancing thromboembolic risk prediction in non-valvular atrial fibrillation: the critical role of transesophageal echocardiography (TEE). Cureus. 2024;16(12):e76064. doi: https://doi.org/10.7759/cureus.76064
  38. Theunissen LJHJ, van de Pol JAA, van Steenbergen GJ, Cremers HP, van Veghel D, van der Voort PH, et al. The prognostic value of quality of life in atrial fibrillation on patient value. Health Qual Life Outcomes. 2023;21(1):33. doi: https://doi.org/10.1186/s12955-023-02112-2
  39. Mobley AR, Subramanian A, Champsi A, Wang X, Myles P, McGreavy P, et al. Thromboembolic events and vascular dementia in patients with atrial fibrillation and low apparent stroke risk. Nat Med. 2024;30(8):2288-94. doi: https://doi.org/10.1038/s41591-024-03049-9
  40. Samaras A, Kartas A, Akrivos E, Fotos G, Dividis G, Vasdeki D, et al. A novel prognostic tool to predict mortality in patients with atrial fibrillation: the BASIC-AF risk score. Hellenic J Cardiol. 2021;62(5):339-48. doi: https://doi.org/10.1016/j.hjc.2021.01.007
  41. van der Endt VHW, Milders J, Penning de Vries BBL, Trines SA, Groenwold RHH, Dekkers OM, et al. Comprehensive comparison of stroke risk score performance: a systematic review and meta-analysis among 6 267 728 patients with atrial fibrillation. Europace. 2022;24(11):1739-53. doi: https://doi.org/10.1093/europace/euac096
  42. Fox KA, Virdone S, Pieper KS, Bassand JP, Camm AJ, Fitzmaurice DA, et al. GARFIELD-AF risk score for mortality, stroke, and bleeding within 2 years in patients with atrial fibrillation. Eur Heart J Qual Care Clin Outcomes. 2022;8(2):214-27. doi: https://doi.org/10.1093/ehjqcco/qcab028
  43. Wallentin L, Lindbäck J, Hijazi Z, Oldgren J, Carnicelli AP, Alexander JH, et al. Biomarker-based model for prediction of ischemic stroke in patients with atrial fibrillation. J Am Coll Cardiol. 2025;85(11):1173-85. doi: https://doi.org/10.1016/j.jacc.2024.11.052
  44. Ali A, Siddiqui AA, Ali M, Shahid I. Meta-analysis on performance of ABC and GARFIELD-AF compared to CHA₂DS₂-VASc and HAS-BLED in anticoagulated atrial fibrillation patients. Cardiovasc Revasc Med. 2024;60:74-81. doi: https://doi.org/10.1016/j.carrev.2023.10.007
  45. Schmalstieg-Bahr K, Gladstone DJ, Hummers E, Suerbaum J, Healey JS, Zapf A, et al. Biomarkers for predicting atrial fibrillation: an explorative sub-analysis of the randomised SCREEN-AF trial. Eur J Gen Pract. 2024;30(1):2327367. doi: https://doi.org/10.1080/13814788.2024.2327367
  46. Diakantonis A, Verras C, Bezati S, Bistola V, Ventoulis I, Velliou M, et al. Predictive value of N-terminal pro B-type natriuretic peptide for short-term outcome of cardioversion in patients with first-diagnosed or paroxysmal atrial fibrillation presenting to the emergency department. Biomedicines. 2024;12(12):2895. doi: https://doi.org/10.3390/biomedicines12122895
  47. Mutirangura P, Kewcharoen J, Navaravong L, Leelaviwat N, Lalitnithi P, Yingchoncharoen P, et al. Prognostic value of troponin on mortality in patients with atrial fibrillation: a systematic review and meta-analysis. J Am Coll Cardiol. 2024;83(13):260. doi: https://doi.org/10.1016/S0735-1097(24)02250-2
  48. Pol T, Hijazi Z, Lindbäck J, Alexander JH, Bahit MC, De Caterina R, et al. Evaluation of the prognostic value of GDF-15, ABC-AF-bleeding score and ABC-AF-death score in patients with atrial fibrillation across different geographical areas. Open Heart. 2021;8(1):e001471. doi: https://doi.org/10.1136/openhrt-2020-001471
  49. Merino-Merino A, González-Bernal J, Fernandez-Zoppino D, Saez-Maleta R, Perez-Rivera J-A, et al. The role of Galectin-3 and ST2 in cardiology: a short review. Biomolecules. 2021;11(8):1167. doi: https://doi.org/10.3390/biom11081167
  50. Pham HN, Ibrahim R, Truong HH, Sainbayar E, Tran VN, Abdelnabi M, et al. Advances in atrial fibrillation management: a guide for general internists. J Clin Med. 2024;13(24):7846. doi: https://doi.org/10.3390/jcm13247846
  51. Dawwas GK, Dietrich E, Cuker A, Barnes GD, Leonard CE, Lewis JD. Effectiveness and safety of direct oral anticoagulants versus warfarin in patients with valvular atrial fibrillation: a population-based cohort study. Ann Intern Med. 2021;174(7):910-9. doi: https://doi.org/10.7326/M20-6194
  52. Li H, Zhang L, Xia M, Zhang C, Jiang T. The comparison of therapeutic efficacy between dabigatran versus warfarin in patients with nonvalvular atrial fibrillation. Clin Appl Thromb Hemost. 2021;27:10760296211044722. doi: https://doi.org/10.1177/10760296211044722
  53. Kolesnyk MY, Mykhailovskyi YM. [Efficacy and safety of warfarin therapy in patients with atrial fibrillation using genotype-guided dosing method]. Zaporozhye Medical Journal. 2022;24(4):390-5. Ukrainian. doi: https://doi.org/10.14739/2310-1210.2022.4.256945
  54. Mykhailovskyi YM. [The influence of clinical and genetic factors on the stability of warfarin’s anticoagulant effect in patients with atrial fibrillation]. Pathologia. 2022;19(1):12-7. Ukrainian. doi: https://doi.org/10.14739/2310-1237.2022.1.252662
  55. Lee JJ, Ha ACT, Dorian P, Verma M, Goodman SG, Friedrich JO, et al. Meta-analysis of safety and efficacy of direct oral anticoagulants versus warfarin according to time in therapeutic range in atrial fibrillation. Am J Cardiol. 2021;140:62-8. doi: https://doi.org/10.1016/j.amjcard.2020.10.064
  56. Del-Toro-Cervera J, Demelo-Rodriguez P, Galeano-Valle F, Fidalgo Á, Sampériz Á, Muñoz-Torrero JFS, et al. Evaluation of the SAMe-TT2R2 score to predict the quality of anticoagulation control in patients with venous thromboembolism treated with vitamin K antagonists: findings from the RIETE registry. Thromb Res. 2020;194:178-82. doi: https://doi.org/10.1016/j.thromres.2020.06.022
  57. Gao X, Cai X, Yang Y, Zhou Y, Zhu W. Diagnostic accuracy of the HAS-BLED bleeding score in VKA- or DOAC-treated patients with atrial fibrillation: a systematic review and meta-analysis. Front Cardiovasc Med. 2021;8:757087. doi: https://doi.org/10.3389/fcvm.2021.757087
  58. Ripoll JG, Chang MG, Bittner EA, Ortoleva J, Khromava M, Bradley DT, et al. Analysis of the 2024 ESC/EACTS guidelines for the management of atrial fibrillation. J Cardiothorac Vasc Anesth. 2025;39(3):818-35. doi: https://doi.org/10.1053/j.jvca.2024.11.020
  59. Soliman EZ, Rahman AK, Zhang Z, Rodriguez CJ, Chang TI, Bates JT, et al. Effect of intensive blood pressure lowering on the risk of atrial fibrillation. Hypertension. 2020;75(6):1491-6. doi: https://doi.org/10.1161/HYPERTENSIONAHA.120.14766
  60. Lian H, Ren Q, Liu W, Zhang R, Zou X, Zhang S, et al. Cardiovascular abnormalities already occurred in newly-diagnosed patients with early-onset type 2 diabetes. Cardiovasc Diabetol. 2025;24(1):140. doi: https://doi.org/10.1186/s12933-025-02665-0
  61. Usman MS, Bhatt DL, Hameed I, Anker SD, Cheng AYC, Hernandez AF, et al. Effect of SGLT2 inhibitors on heart failure outcomes and cardiovascular death across the cardiometabolic disease spectrum: a systematic review and meta-analysis. Lancet Diabetes Endocrinol. 2024;12(7):447-61. doi: https://doi.org/10.1016/S2213-8587(24)00102-5
  62. Zelniker TA, Bonaca MP, Furtado RHM, Mosenzon O, Kato ET, Cahn A, et al. Effect of dapagliflozin on atrial fibrillation in patients with type 2 diabetes mellitus: insights from the DECLARE-TIMI 58 trial. Circulation. 2020;141(15):1227-34. doi: https://doi.org/10.1161/CIRCULATIONAHA.119.044183
  63. Schumacher CA, Van Dril EK, Shealy KM, Goldman JD. Optimizing management of type 2 diabetes and its complications in patients with heart failure. Clin Diabetes. 2021;39(1):105-16. doi: https://doi.org/10.2337/cd20-0008
  64. Abdel-Qadir H, Gunn M, Lega IC, Pang A, Austin PC, Singh SM, et al. Association of diabetes duration and glycemic control with stroke rate in patients with atrial fibrillation and diabetes: a population-based cohort study. J Am Heart Assoc. 2022;11(4):e023643. doi: https://doi.org/10.1161/JAHA.121.023643
  65. Kirchhof P, Camm AJ, Goette A, Brandes A, Eckardt L, Elvan A, et al. Early rhythm-control therapy in patients with atrial fibrillation. N Engl J Med. 2020;383(14):1305-16. doi: https://doi.org/10.1056/NEJMoa2019422
  66. Mundisugih J, Franke KB, Tully PJ, Munawar DA, Kumar S, Mahajan R, et al. Prevalence and prognostic implication of atrial fibrillation in heart failure subtypes: systematic review and meta-analysis. Heart Lung Circ. 2023;32(6):666-77. doi: https://doi.org/10.1016/j.hlc.2023.02.009
  67. Sha R, Baines O, Hayes A, Tompkins K, Kalla M, Holmes AP, et al. Impact of obesity on atrial fibrillation pathogenesis and treatment options. J Am Heart Assoc. 2024;13(1):e032277. doi: https://doi.org/10.1161/JAHA.123.032277
  68. Javed S, Koniari I, Fox D, Skene C, Lip GYH, Gupta D. Catheter ablation for atrial fibrillation in heart failure: untying the Gordian knot. J Geriatr Cardiol. 2021;18(4):297-306. doi: 10.11909/j.issn.1671-5411.2021.04.002
  69. McDonagh TA, Metra M, Adamo M, Gardner RS, Baumbach A, Coats AJS, et al. 2023 Focused update of the 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2023;44(37):3627-39. doi: https://doi.org/10.1093/eurheartj/ehad195
  70. Potpara TS, Mujovic N, Proietti M, Dagres N, Hindricks G, Collet JP, et al. Revisiting the effects of omitting aspirin in combined antithrombotic therapies for atrial fibrillation and acute coronary syndromes or percutaneous coronary interventions: meta-analysis of pooled data from the PIONEER AF-PCI, RE-DUAL PCI, and AUGUSTUS trials. Europace. 2020;22(1):33-46. doi: https://doi.org/10.1093/europace/euz259
  71. Kumbhani DJ, Cannon CP, Beavers CJ, Bhatt DL, Cuker A, Gluckman TJ, et al. 2020 ACC expert consensus decision pathway for anticoagulant and antiplatelet therapy in patients with atrial fibrillation or venous thromboembolism undergoing percutaneous coronary intervention or with atherosclerotic cardiovascular disease: a report of the American College of Cardiology Solution Set Oversight Committee. J Am Coll Cardiol. 2021;77(5):629-58. doi: https://doi.org/10.1016/j.jacc.2020.09.011
  72. Magnocavallo M, Bellasi A, Mariani MV, Fusaro M, Ravera M, Paoletti E, et al. Thromboembolic and bleeding risk in atrial fibrillation patients with chronic kidney disease: role of anticoagulation therapy. J Clin Med. 2021;10(1):83. doi: https://doi.org/10.3390/jcm10010083
  73. Steffel J, Collins R, Antz M, Desteghe L, Haeusler KG, Oldgren J, et al. Updated European Heart Rhythm Association practical guide on the use of non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. Europace. 2021;23(10):1612-76. doi: https://doi.org/10.1093/europace/euab065
  74. Zhao M, Song L, Zhao Q, Chen Y, Li B, Xie Z, et al. Elevated levels of body mass index and waist circumference, but not high variability, are associated with an increased risk of atrial fibrillation. BMC Med. 2022;20(1):215. doi: https://doi.org/10.1186/s12916-022-02413-1
  75. Novaes Lima Filho AI, do Rego Barros MC, de Barros Guimarães AA, Sobral Filho DC. Obesity paradox in atrial fibrillation and its relation with the new oral anticoagulants. Curr Cardiol Rev. 2022;18(5):8-10. doi: https://doi.org/10.2174/1573403X18666220324111343
  76. Linz D, Nattel S, Kalman JM, Sanders P. Sleep apnea and atrial fibrillation. Card Electrophysiol Clin. 2021;13(1):87-94. doi: https://doi.org/10.1016/j.ccep.2020.10.003
  77. Voskoboinik A, Kalman JM, De Silva A, Nicholls T, Costello B, Nanayakkara S, et al. Alcohol abstinence in drinkers with atrial fibrillation. N Engl J Med. 2020;382(1):20-8. doi: https://doi.org/10.1056/NEJMoa1817591
  78. Franklin BA, Eijsvogels TM, Pandey A, Quindry J, Toth PP. Physical activity, cardiorespiratory fitness, and cardiovascular health: a clinical practice statement of the American Society for Preventive Cardiology Part II: physical activity, cardiorespiratory fitness, minimum and goal intensities for exercise training, prescriptive methods, and special patient populations. Am J Prev Cardiol. 2022;12:100425. doi: https://doi.org/10.1016/j.ajpc.2022.100425

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Mykhailovska NS, Lytvynenko RV, Mykhailovskyi YM, Shershnyova OV. Modern guidelines for the management of patients with atrial fibrillation and comorbid conditions: a literature review. Zaporozhye Medical Journal [Internet]. 2025Dec.15 [cited 2026May14];27(6):501-1. Available from: https://zmj.zsmu.edu.ua/article/view/336900

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Vol. 27 No. 6 (2025)

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