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Weight loss improves atrial fibrillation symptoms

Intensive weight loss programmes can significantly reduce atrial fibrillation symptoms in overweight and obese patients, according to a study published this week.

Researchers in Australia studied 150 patients with symptomatic atrial fibrillation, with an average BMI of around 33 kg/m2, who were randomly assigned to undergo a physician-led weight loss programme or receive general lifestyle advice, on top of usual risk factor management.

Over a median of 15 months of follow-up, patients in the weight-loss intervention group lost an average of 14.3 kg in weight compared with 3.6 kg in the lifestyle advice group.

The intervention group had a significantly greater reduction in atrial fibrillation symptom burden and symptom severity scores, as well as in the number of episodes and cumulative duration of episodes.

Reporting their findings in a paper in JAMA, the Royal Adelaide Hospital researchers said obesity is a major driver of the increasing prevalence of atrial fibrillation, along with an ageing population.

They concluded: ‘In this study, a structured weight management programme for highly symptomatic patients with atrial fibrillation reduced symptom burden and severity and reduced antiarrhythmic use when compared with attempts to optimally manage risk factors alone.

‘The beneficial effects may be attributable to decrease in left atrial area and ventricular wall thickness, thereby reducing the left atrial hypertension that is a common finding in obese patients.’

JAMA 2013; available online 17 November

 

 Weight management (n=150)

Lifestyle advice

(n=150)

Symptom burden (Atrial Fibrillation Symptom Severity score)-11.8-2.6
Symptom severity (AFSS score)-8.4-1.7
No. episodes-2.5 No change
Duration episodes-692 min+419 min

Main findings: Change in primary and secondary endpoints from baseline to 15 months (all p<0.001)

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