Saturday, April 26, 2014

Weight reduction as a treatment modality in atrial fibrillation

Obesity has become increasingly recognized as a driver of atrial fibrillation. The topic was recently reviewed in this paper and I provided some background here. Now for the first time a study in JAMA suggests that weight reduction lowers the arrhythmia burden in obese patients who have atrial fibrillation:

Design, Setting, and Patients Single-center, partially blinded, randomized controlled study conducted between June 2010 and December 2011 in Adelaide, Australia, among overweight and obese ambulatory patients (N = 150) with symptomatic atrial fibrillation. Patients underwent a median of 15 months of follow-up.
Interventions Patients were randomized to weight management (intervention) or general lifestyle advice (control). Both groups underwent intensive management of cardiometabolic risk factors...
Results Of 248 patients screened, 150 were randomized (75 per group) and underwent follow-up. The intervention group showed a significantly greater reduction, compared with the control group, in weight (14.3 and 3.6 kg, respectively; P less than .001) and in atrial fibrillation symptom burden scores (11.8 and 2.6 points, P less than .001), symptom severity scores (8.4 and 1.7 points, P less than .001), number of episodes (2.5 and no change, P = .01), and cumulative duration (692-minute decline and 419-minute increase, P = .002). Additionally, there was a reduction in interventricular septal thickness in the intervention and control groups (1.1 and 0.6 mm, P = .02) and left atrial area (3.5 and 1.9 cm2, P = .02).

More about the study from Medscape Cardiology.

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