Weight loss prior to heart procedure improves outcomes in overweight people

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A new clinical trial led by researchers at UHealth—the University of Miami Health System and the Miller School of Medicine found that overweight and obese patients with persistent and paroxysmal atrial fibrillation (AF) showed improved outcomes if they lost weight before undergoing a catheter ablation procedure.

The results were presented at Heart Rhythm 2023 and could change how doctors approach the treatment of AF.

Atrial Fibrillation and Its Prevalence

AF is the most common type of arrhythmia, affecting around 2.3 million people in the United States with 160,000 new cases diagnosed every year.

It’s frequently treated with catheter ablation when medications aren’t effective or when the arrhythmias originate from the heart’s upper chambers.

The Study on Weight Loss and AF

While catheter ablation is a typical treatment, researchers continue to look for ways to improve outcomes for AF patients.

This trial focused on whether integrating non-ablation therapy targets into treatment plans could benefit patients with persistent and paroxysmal AF undergoing catheter ablation.

The study involved 65 patients with a body mass index (BMI) of 27 kg/m2 or higher who chose catheter ablation for their AF treatment.

These patients were then divided into two groups based on whether they experienced a weight change of less than 3% (Group 1) or a weight change between 3% and 10% (Group 2) prior to the ablation procedure.

Results Show Improved Outcomes

The results revealed differences in AF status from enrollment to six months post-ablation. Group 1, which experienced a weight gain of 0.2±2.7%, had a 61% freedom from AF off antiarrhythmic drugs at six months.

Meanwhile, Group 2, which saw a weight loss of 5.6±1.8%, had an 88% freedom from AF off antiarrhythmic drugs in the same timeframe.

For those with persistent AF treated with ablation, the 6-month and 12-month freedom from AF off antiarrhythmic drugs was significantly higher in Group 2 compared to Group 1.

The Impact of Weight on AF Treatment

Dr. Jeffrey Goldberger, M.D., M.B.A, Director, Center for Atrial Fibrillation at UHealth, commented on the study, “We believe the magnitude of the effect during this study is quite striking and that the findings show that even moderate weight loss may lead to a positive effect.”

He emphasized the need for further analysis, but the results strongly suggest that weight loss can significantly improve outcomes for AF patients undergoing catheter ablation.

The researchers hope their findings will encourage physicians to incorporate weight loss and risk factor modification into treatment plans for patients undergoing catheter ablation.

Future trials could provide further insight into the role of weight and weight loss in improving AF ablation outcomes and possibly identifying new procedural approaches.

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