ASSOCIATION BETWEEN ATRIAL FIBRILLATION AND METABOLIC SYNDROME: A SYSTEMATIC REVIEW

Abstract

Atrial fibrillation is the most prevalent sustained arrhythmia, associated with increased risk of stroke, heart failure, and mortality. Metabolic syndrome, defined by visceral obesity, hypertension, insulin resistance, and dyslipidemia, represents an important cardiometabolic risk factor. Recent evidence indicates that the interaction between these conditions is not merely additive but results from interconnected pathophysiological mechanisms involving atrial remodeling, chronic inflammation, and cellular metabolic alterations. This systematic review aimed to analyze evidence published in the last ten years on the association between atrial fibrillation and metabolic syndrome, highlighting shared mechanisms, clinical impact, and therapeutic implications. A search was performed in PubMed/MEDLINE, SciELO, LILACS, and the Virtual Health Library, including publications from January 2015 to September 2025, without language restriction, provided they were freely accessible. Observational studies, experimental research, and systematic reviews involving adults diagnosed with both conditions were included. Nine articles met the inclusion criteria. The findings showed that metabolic syndrome increases the incidence and persistence of atrial fibrillation, with a progressive risk related to the cumulative burden of metabolic factors and phenotypic transitions over time. Visceral obesity and metabolic dysfunction–associated fatty liver disease were identified as relevant contributors. In conclusion, this association should be understood as an expression of a broader cardiometabolic spectrum, requiring integrated management and early interventions.