Atrial Fibrillation

Polygenic risk

People with high polygenic risk scores are about twice as likely to develop atrial fibrillation as people who aren't in the high-risk category.

This estimate is based on data from people of African, European, and Hispanic or Latino ancestry. Information is lacking or not available for those of other ancestries.

For participants with a high polygenic risk score, recommendations include:

  • Ask about symptoms including:
    • Heart palpitations.
    • Irregular heart rhythm or rate.
    • A feeling of skipped beats or irregular beats that last for a few seconds or more.
    • Fainting.
    • Unusual dizzy spells.
  • Assess for other risks factors for atrial fibrillation, such as:
    • Being over 65.
    • High blood pressure.
    • Diabetes.
    • Heart failure.
    • History of stroke.
    • Kidney failure.
    • Overactive thyroid.
    • Obesity.
    • Sleep apnea.
    • Smoking.
    • Heavy alcohol use.
  • For people 40 or older, consider a cardiac screening or a cardiology consultation, which could include:
    • Checking pulse for irregularities.
    • Having a 12-lead ECG.
    • Monitoring heart activity. This could be with a short-term monitor such as a Holter or ZIO Patch, a 30-day event monitor, or an implantable loop recorder.
    • Having an echocardiogram.
    • Using a watch or other device with heart-monitoring capabilities, if available and affordable.

Monogenic risk

Monogenic risk of atrial fibrillation can be due to variants in the LMNA gene. People with these genetic variants have a greater chance of:

For participants with monogenic risk, recommendations include:

  • Referral to a genetic counselor.
  • Perform a cardiac screening or a cardiology consultation, which could include:
    • Checking pulse for irregularities.
    • Doing a 12-lead ECG.
    • Monitoring heart activity. This could be with a short-term monitor such as a Holter or ZIO Patch, a 30-day event monitor, or an implantable loop recorder.
    • Doing an echocardiogram.
    • Recommending use of a watch or other device with heart-monitoring capabilities, if available and affordable.

Family History

A participant has a family history of atrial fibrillation if one or both of their parents developed atrial fibrillation before age 75.

For participants with a family history of atrial fibrillation, recommendations include:

  • Consider monogenic testing with an arrhythmia gene panel that includes the TTN and LMNA genes and others.
  • For people 40 or older, consider a cardiac screening or a cardiology consultation, which could include:
    • Checking pulse for irregularities.
    • Doing a 12-lead ECG.
    • Monitoring heart activity. This could be with a short-term monitor such as a Holter or ZIO Patch, a 30-day event monitor, or an implantable loop recorder.
    • Doing an echocardiogram.
    • Recommending use of a watch or other device with heart-monitoring capabilities, if available and affordable.