Weight reduction >8.3% in obese patients on AADs at 12 months led to AF burden comparable to catheter ablation, despite overall AF burden being higher in other tertiles.
Does significant weight loss combined with antiarrhythmic drugs reduce atrial fibrillation burden comparably to catheter ablation in obese patients with atrial fibrillation?
In obese patients with atrial fibrillation, achieving >8.3% weight loss combined with antiarrhythmic drugs yields an AF burden at 12 months that is comparable to catheter ablation.
Absolute Event Rate: 0% vs 0%
Abstract Background and Aims In the PRAGUE-25 study, the effect of lifestyle modification (LFM) in combination with antiarrhythmic drugs (AAD) in patients with atrial fibrillation (AF) and BMI 30-40 was smaller than that of catheter ablation (CA). The presented sub-analysis aims to assess the relationship between the actual weight reduction and the AF burden 12 months after randomization. Methods Per-protocol analysis of the PRAGUE-25 trial. Patients in the LFM+AAD group were stratified into tertiles based on the extent of relative weight reduction, and a comparison of AF burden was performed between the LFM+AAD tertiles and the CA group. Results The study analyzed 83 LFM+AAD patients (age 60 ±9 years, 31% women, 54% paroxysmal AF, mean weight 109±17 kg) and 99 CA patients (age 60±9 years, 32% women, 56% paroxysmal AF, weight 109±15 kg). Within the LFM+AAD group, 28 patients achieved a weight reduction of 8.3% (−15.46±6.16 kg), 27 patients were between 3.1–8.1% (−6.56±2.28 kg), and 28 patients were 3.1% (+1.38±4.03 kg). Compared to the CA group, the AF burden at 12 months (0 IQR 0–0) was significantly higher in the second (3.5% 0; 52 and third (10; 47 LFM-ADD tertiles, but did not differ from CA in the first tertile (0% 0; 11., p=0.17). Conclusion In obese patients, the maintenance of SR on AADs is related to the level of weight reduction. The efficacy of AADs in obese patients with a significant weight loss at 12-months follow-up is close to catheter ablation, although the overall AF burden is still non-significantly higher.
Heřman et al. (Thu,) reported a other. Weight reduction >8.3% in obese patients on AADs at 12 months led to AF burden comparable to catheter ablation, despite overall AF burden being higher in other tertiles.