Introduction: The metabolic syndrome (MS) consists of pathological changes as diabetes, hypertension, obesity, and dyslipidemia, most of them also have been founded in the pathogenesis of atrial fibrillation (AF). However, the role of the MS in the development of AF was not detected.

Aim: To explore the clinical features of the comorbidity of MS and AF, impact of the MS on the severity of AF and suggest the possible management approaches.

Material and methods: We conducted a randomized study: 186 patients were enrolled in the Sumy Region Affair Hospital, among those patients 79 (42.47%) had paroxysmal AF and 108 (57.53%) had permanent AF. They were divided into two groups: group A – 86 patients (46.23%) with AF and MS, and group B – 101 patients (53.77%) with isolated AF. Our patients have been subjected to physical examination, blood tests (glucose, lipid profile), 12-lead ECG and EchoCG. The authors had full access to and take full responsibility for the integrity of the data.

Results: It was not found a significant difference in the prevalence of hypertension between group with MS and group without MS, while there is a significant difference in prevalence of other variables, such as overweight/obesity, hypertriglyceridemia, hyperglycemia, and low HDL-C (p<0.05). It was detected that AF severity could be controlled by treatment of metabolic syndrome, including lifestyle modification, metformin 1000 mg/day and atorvastatin 80 mg/day (p<0.05).

Conclusions: MS is associated with increased risk of permanent AF. Correction of metabolic risk factors can help to control AF.