{
  "abstract": "Background Guidelines recommend systematic identification and management of modifiable risk factors (RFs) in atrial fibrillation (AF) to reduce recurrence and improve outcomes. The effectiveness of routine, single-visit outpatient interventions remains unclear.Objectives To assess screening, prevalence, control, and management of modifiable RFs in patients referred for direct current cardioversion (DCCV) or catheter ablation (CA), and their association with AF recurrence.Methods In this single-centre retrospective cohort study, 325 consecutive AF patients referred for DCCV or CA over two years were analysed. Electronic records were reviewed for RF screening (hypertension, elevated body mass index, diabetes mellitus, sleep-disordered breathing, alcohol misuse), RF control status, and RF management at clinic. AF recurrence was ascertained from follow-up documentation with a median follow-up of 23 (IQR 18-30) months. AF-free survival was evaluated using Kaplan–Meier curves and log-rank tests; Cox proportional hazards regression estimated hazard ratios (HRs) with 95% confidence intervals (CIs).Results 89% of patients had ≥1 modifiable RF; only 25% of those were fully controlled. AF recurred in 58% of patients. AF-free survival decreased with increasing RF burden (log-rank p=0.04; HR 2.16 for >3 vs 0–1 RFs, 95% CI 1.19–3.91). Among patients with ≥1 uncontrolled RF, AF-free survival did not differ according to whether the RFs were fully managed, partially managed, or unmanaged at the clinic visit (log-rank p=0.7; Cox HR 1.21–1.33, all p>0.4).Conclusions Modifiable RFs are highly prevalent and often uncontrolled. Brief, single-visit interventions appear insufficient to reduce AF recurrence, highlighting the need for structured, sustained RF management strategies.",
  "authors": [
    {
      "affiliations": [
        "Cardiology Department, Royal United Hospital, Bath, United Kingdom"
      ],
      "name": "Kieran Strong"
    },
    {
      "affiliations": [
        "Cardiology Department, Royal United Hospital, Bath, United Kingdom",
        "Department of Health, University of Bath, Bath, United Kingdom"
      ],
      "name": "David Murphy"
    },
    {
      "affiliations": [
        "Cardiology Department, Royal United Hospital, Bath, United Kingdom",
        "Department of Health, University of Bath, Bath, United Kingdom"
      ],
      "name": "John Graby"
    },
    {
      "affiliations": [
        "Department of Health, University of Bath, Bath, United Kingdom",
        "Radiology Department, Royal United Hospital, Bath, United Kingdom"
      ],
      "name": "Jonathan CL Rodrigues"
    },
    {
      "affiliations": [
        "Department of Health, University of Bath, Bath, United Kingdom"
      ],
      "name": "Dylan Thompson"
    },
    {
      "affiliations": [
        "Cardiology Department, Royal United Hospital, Bath, United Kingdom"
      ],
      "name": "Ali Khavandi"
    }
  ],
  "title": "240 Prevalence and management of modifiable risk factors in atrial fibrillation: limitations of single-visit outpatient interventions",
  "uid": "8cef51de-8018-5d58-8873-c83bc6260870"
}