The Relationshi̇p Between Ehra and Mediterranean Diet Scores in Patients With Atrial Fibrillation: Evaluation of Dietary Approaches in Patients Undergoing Cathether Ablation Therapy

Introduction: Atrial fibrillation (AF) is a common arrhythmia associated with increased morbidity and mortality. Symptom severity in AF patients is classified using the European Heart Rhythm Association (EHRA) score. While AF development is multifactorial, dietary patterns may play a role in its progression and symptom burden. The Mediterranean diet (MD), known for its cardioprotective effects, has been associated with reduced cardiovascular risk factors. However, its relationship with AF symptom severity remains underexplored. This study investigates the association between Mediterranean Diet Score (MDS) and EHRA scores in AF patients. Methods: This cross-sectional study included AF patients from a cardiology outpatient clinic. Patients were classified into four groups based on EHRA scores. Adherence to the Mediterranean diet was assessed using a 14-item questionnaire, with scores categorized as low (≤5), moderate (6-9), or high (≥10). Statistical analyses were conducted to evaluate the correlation between MDS and EHRA scores. Results: Higher MDS was significantly associated with lower EHRA scores (p < 0.001). A strong inverse correlation was observed between MDS and EHRA scores (Pearson r = -0.61, p < 0.0001; Spearman r = -0.63, p < 0.0001). While no significant differences in macronutrient intake were found among EHRA groups, patients with higher EHRA scores tended to consume slightly more calories, suggesting dietary quality rather than total intake may impact AF symptom severity. Conclusion: Greater adherence to the Mediterranean diet is associated with lower symptom burden in AF patients. These findings highlight the potential role of dietary interventions as a non-pharmacological approach to AF management. Future studies, including randomized controlled trials, are needed to further explore dietary modifications as part of comprehensive AF treatment strategies.