‘Out of sync’: a qualitative investigation of patients’ experiences of atrial fibrillation and perceptions of weight management

Objectives To explore ways to enhance the design of risk factor management and weight-loss services for people with overweight/obesity and atrial fibrillation (AF). Background AF is the most common cardiac arrhythmia, with serious consequences for health and quality of life. Some evidence indicates weight reduction in people with AF and overweight/obesity may improve symptoms. This population may require additional support with weight management due to factors associated with ageing and health. Design Qualitative investigation based on semi-structured interviews. Methods 12 adult participants (4 female, 8 male) with diagnosed AF and a current or previous body mass index >27 kg/m2were recruited at a large tertiary cardiac referral centre in southern England between September 2020 and January 2021. Participants completed quality of life and AF symptom questionnaires using Think-Aloud technique and semi-structured interviews relating to their weight management experiences, needs and preferences. Interviews were audio recorded and analysed thematically using the Capability, Opportunity and Motivation-Behaviour model as a theoretical framework. Results Three main themes were identified.Being out of rhythmexplores the psychological and physical impact of AF on weight management;doing the right thingdiscusses participants’ weight management experiences andbroaching the subjectexplores participants’ perspectives on weight management conversations with clinicians. Conclusions There was dissatisfaction with the weight management advice received from healthcare professionals including cardiologists. Participants wanted open, non-judgemental discussion of cardiac health implications of overweight/obesity supported by referral to weight management services. Improved communication including research findings regarding the benefits of weight loss as a factor in AF management might increase motivation to adhere to weight-loss advice in this population.