Weight loss ≥10% yielded a 6-fold greater probability of arrhythmia-free survival compared with lesser weight loss (95% CI 3.4-10.3; p<0.001), while weight fluctuation >5% increased recurrence risk.
Cohort (n=355)
Does goal-directed weight management reduce AF burden and improve arrhythmia-free survival in obese patients with atrial fibrillation?
355 obese individuals (BMI ≥ 27 kg/m²) with atrial fibrillation
Goal-directed weight management achieving ≥ 10% weight loss (group 1) or 3% to 9% weight loss (group 2)
Goal-directed weight management achieving < 3% weight loss (group 3)
Arrhythmia-free survival, AF burden (via 7-day ambulatory monitoring), and symptom severity (via AF severity scale)
Sustained weight loss of ≥10% significantly improves arrhythmia-free survival and reduces AF burden in obese patients with atrial fibrillation.
Effect estimate: 6-fold greater probability (95% CI 3.4 to 10.3)
p-value: p=<0.001
BACKGROUND: Obesity and atrial fibrillation (AF) frequently coexist. Weight loss reduces the burden of AF, but whether this is sustained, has a dose effect, or is influenced by weight fluctuation is unknown. OBJECTIVES: This study sought to evaluate the long-term impact of weight loss and weight fluctuation on rhythm control in obese individuals with AF. METHODS: Of 1,415 consecutive patients with AF, 825 had a body mass index ≥ 27 kg/m(2) and were offered weight management. After screening for exclusion criteria, 355 were included in this analysis. Weight loss was categorized as group 1 (≥ 10%), group 2 (3% to 9%), and group 3 (5% partially offset this benefit, with a 2-fold (95% confidence interval: 1.0 to 4.3; p = 0.02) increased risk of arrhythmia recurrence. CONCLUSIONS: Long-term sustained weight loss is associated with significant reduction of AF burden and maintenance of sinus rhythm. (Long-Term Effect of Goal directed weight management on Atrial Fibrillation Cohort: A 5 Year follow-up study LEGACY Study; ACTRN12614001123639).
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Rajeev K. Pathak
Electrophysiology
Melissa E. Middeldorp
Electrophysiology
Megan Meredith
University of Sussex
Journal of the American College of Cardiology
University of Oxford
The University of Melbourne
Australian National University
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Pathak et al. (Mon,) conducted a cohort in Atrial Fibrillation and Obesity (n=355). Weight loss (≥ 10%) vs. Weight loss 3% to 9% or <3% was evaluated on Arrhythmia-free survival (6-fold greater probability, 95% CI 3.4 to 10.3, p=<0.001). Weight loss ≥10% yielded a 6-fold greater probability of arrhythmia-free survival compared with lesser weight loss (95% CI 3.4-10.3; p<0.001), while weight fluctuation >5% increased recurrence risk.
synapsesocial.com/papers/6a0c2b08aff5732a0d7306f8 — DOI: https://doi.org/10.1016/j.jacc.2015.03.002
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