Applies whatever the score Always
af-risk-factorsNo one has reached this rule yetWeight loss, alcohol reduction, sleep apnea treatment, blood pressure control
No clinician has signed off this rule yet. It reflects our reading of the guidelines cited below, which has not been independently checked.
Word for word, as generated for the example person below. Figures in the text are theirs.
Atrial fibrillation responds to weight loss, alcohol reduction, and treating sleep apnea more than almost any other rhythm problem. This is genuinely modifiable.
In the LEGACY study, sustained weight loss of 10% or more produced roughly a six-fold higher chance of staying free of AF, and the benefit tracked how well the weight stayed off. Cutting alcohol reduces recurrence in a dose-dependent way — this is one of the clearest alcohol-outcome relationships in cardiology. Untreated obstructive sleep apnea substantially raises the chance AF comes back after a successful ablation, which is why it is worth testing for before paying for one. Blood pressure control belongs on the same list.
Outcome-provenTested in randomised trials measuring heart attacks, strokes, or death, not a stand-in for them.· Class I· Level B-R· checked 2026-09-12
2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation · Class I
Promising evidence that hasn't become standard care yet — worth knowing, not yet worth expecting.
If you genuinely cannot take an anticoagulant long term, left atrial appendage closure is the established alternative — not aspirin.
Most AF-related clots form in the left atrial appendage, and a catheter-delivered device can seal it off. It is an established option for people with a real contraindication to long-term anticoagulation rather than a preference against it, and it is a procedure with its own risks. Raise it only after the reasons for avoiding anticoagulation have been properly examined, because those reasons are often modifiable.
Outcome-provenTested in randomised trials measuring heart attacks, strokes, or death, not a stand-in for them.· Class 2a· Level B-R· checked 2026-09-12
2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation · Class 2a in selected patients
“Atrial fibrillation, blood thinner not yet discussed” — an illustrative profile, not a real user.
Asked after: Atrial fibrillation
Cited by the recommendations above.
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Runs in lib/engine/afPathway.ts as af-risk-factors.