Feasibility of weight loss in obese atrial fibrillation patients attending a specialist arrhythmia clinic and its impact on ablation outcomes

Yew Ding, Wern, Kozhuharov, Nikola, Hao Chin, Shui, Shaw, Matthew, Snowdon, Richard, Lip, Gregory YH ORCID: 0000-0002-7566-1626 and Gupta, Dhiraj (2020) Feasibility of weight loss in obese atrial fibrillation patients attending a specialist arrhythmia clinic and its impact on ablation outcomes. Journal of Arrhythmia, 36 (6). pp. 984-990.

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Official URL: http://dx.doi.org/10.1002/joa3.12432

Abstract

<h4>Background</h4>The feasibility of significant weight reduction in a specialist arrhythmia service, and its impact on atrial fibrillation (AF) ablation outcomes are unclear. We aimed to assess these factors in a real-world cohort in the United Kingdom.<h4>Methods</h4>Patients from one specialized arrhythmia clinic were instructed to follow the "Intermittent Fasting 5:2 diet" ("diet group", n = 50), and their outcomes were compared to a propensity matched cohort who received no specific dietary advice ("control group", n = 42). The primary outcome was recurrence of AF or atrial tachycardia (AT) at 12 months postablation, with or without drugs.<h4>Results</h4>Body weight and body mass index (BMI) at baseline were 105.0 (±15.3) kgs and 36.0 (±4.0), respectively. Baseline characteristics between the two groups were comparable. Patients in diet group experienced a mean weight loss of 8.2 (±7.1) kgs prior to AF ablation (<i>P</i> < .01 for comparison to baseline and control group). About 14 (28%) patients in the diet group lost >10% of their body weight. Overall, 11 (22%) patients in the diet group and five (12%) in the control group had AF recurrence at 1 year, <i>P</i> = .21. AF recurrence was similar in patients with BMI ≥ 35 (15%) as compared to BMI < 35 (19%), <i>P</i> = .60. There was one procedural complication (pulmonary edema) in the diet group.<h4>Conclusion</h4>It is feasible to achieve significant weight reduction in obese AF patients in a specialist arrhythmia clinic setting with unsupervised dietary advice. Low rates of procedural complications and excellent medium-term success rates were observed in this traditionally challenging population. Additional improvements in outcomes were not demonstrable in patients who exhibited significant weight loss.

Item Type:	Article
Uncontrolled Keywords:	ablation, atrial fibrillation, outcome, specialist clinic, weight loss
Depositing User:	Symplectic Admin
Date Deposited:	13 Oct 2020 09:41
Last Modified:	18 Jan 2023 23:28
DOI:	10.1002/joa3.12432
Related URLs:	Author Publisher
URI:	https://livrepository.liverpool.ac.uk/id/eprint/3104073