CANet — Cardiac Arrhythmia Network of Canada

Cardiovascular Risk Factor Modification to Reduce Atrial Fibrillation Burden

Atrial fibrillation, or AF, is a heart rhythm disorder and a major health problem in Canada with high economic costs. Not only are AF patients afflicted with symptoms that seriously compromise their capacity to lead normal lives (palpitations, laboured breathing, fatigue, dizziness, mental disturbances), they also face high risks of stroke, bleeding complications and heart failure. Risk factors for cardiovascular disease such as being overweight/obese, having high blood pressure, high cholesterol and diabetes, physical inactivity, smoking, alcohol use and sleep disorders have been linked to AF.

Currently, lifestyle programs targeting cardiovascular risk factors are not prescribed for AF, though they are for other heart diseases and recent research has shown that such programs may improve the health (i.e. fitness, blood pressure, cholesterol, heart function, medication use, symptoms and quality of life) of people with AF. The absence of lifestyle programs, in the face of building evidence for its benefits, is a lost opportunity for patients with AF searching for better treatment options.

There is an increasing emphasis for patients and their caregivers to be included when establishing priorities for research in health care – “nothing about me without me.” Since patients live with their disease, persons living with AF and their caregivers become experts in their disease. Sadly, there is no research seeking advice from patients, their caregivers or health care professionals who care for those with AF to identify unanswered questions about the management of cardiovascular risk factors among patients with AF.

The main goal of our project is to identify the most important unanswered questions about managing cardiovascular risk factors based on the opinions of adults living with AF, their caregivers and the health care professionals who care for these patients. This will be done in several steps. First, we will invite patients, caregivers, health care professionals, researchers, government organizations, and volunteer organizations to form an expert committee to develop a questionnaire about body weight, physical activity, nutrition, blood pressure, blood sugar, alcohol use, medication use, sleep, symptoms, and psychosocial issues. Second, we will collect unanswered questions about managing cardiovascular risk factors through a national survey. Third, we will assemble a shortlist of the top 30 unanswered research questions. Lastly, the expert committee will meet to determine the top 10 unanswered research questions.

The strength of this work will be the engagement of patients and knowledge users (i.e. caregivers, clinicians, researchers, industry partners, government organizations, volunteer organizations, etc.) throughout the assessment and decision-making process to identify research priorities for patients with AF who are searching for better treatment options. This work is important in developing the right kind of programs and for targeting the most important issues to reduce the burden of AF.