What's new?Lipoprotein(a) [Lp(a)], a variant of low-density lipoprotein, is an established causal risk factor for atherosclerotic cardiovascular disease and aortic stenosis.While evidence supporting its role in other conditions is limited, some studies reported it played a pathophysiological role in atrial fibrillation (AF).This research systematically reviews current knowledge on the role of Lp(a) in AF, providing a study-by-study analysis and overall conclusions.To the best of our knowledge, this is the first systematic review of the role of Lp(a) in AF that includes various study types.We found little evidence to support the association between Lp(a) levels and AF incidence.However, the genetic studies show a causal relationship between high Lp(a) and AF.Among AF patients, those who experienced thromboembolic events had higher Lp(a) concentrations than those who did not.