Table 1.

Modifiable promoters of atrial fibrillation.

Mechanism	Etiology	Specific treatment options
Myocardial stretch (atrial hypertension, atrial dilatation, reduced contractility)	Fluid overload Acute mitral insufficiency Mitral stenosis	Fluid removal (restrictive fluid administration, diuretics, renal replacement therapy) Intra-aortic balloon pump; cardiac surgery Valvuloplasty
Inappropriate oxygen delivery to the myocardium	Myocardial ischemia Hypovolemia Anemia	Revascularization Fluid challenge Transfusion of red blood cells
Electrolyte disturbances (risk factors: diuretics, dialysis)	Hypokalemia Hypomagnesemia	Substitution of potassium (goal K+ 4.5–5.5 mmol/L) Substitution of magnesium (goal Mg++ > 1.0 mmol/L)
Systemic and local inflammation	Heart-lung machine Sepsis Myocarditis	Steroids; off-pump cardiosurgical techniques Antimicrobial therapy Immunosuppression
Adrenergic overstimulation	Inotropic support Stress (pain, anxiety)	Reduction of inotropes Sedation; analgesia; betablockers
Endocrine disorder	Elevated thyroid hormones Pheochromocytoma	Betablockers; thyreostatic drugs Alpha- and betablockers
Various	Hypothermia	Correction of hypothermia