Obese patients suffering from atrial fibrillation (Afib) who lose at least 10% of their body weight greatly increase their chances of achieving long-term freedom from this common heart rhythm disorder, according to research from the University of Adelaide. The results of the study, from the university's Centre for Heart Rhythm Disorders, also show that patients receive the best results from a dedicated, in-clinic weight loss programme.
"This study is the first to track the long-term effects of weight loss and the degree of weight fluctuation on atrial fibrillation," says lead author Dr Rajeev Pathak, a cardiologist and electro-physiology fellow at the University of Adelaide and PhD student under Professor Prash Sanders in the Centre for Heart Rhythm Disorders.
"Patients who lost more weight and maintained a more stable weight over four years showed marked reductions in atrial fibrillation burden and severity, the study’s primary endpoints," he says.
"In a key finding, obese patients who lost at least 10% of their body weight were six times as likely to achieve long-term freedom from atrial fibrillation compared to those who did not lose weight."
Pathak says weight loss also led to favourable changes in cardiovascular risk factors, such as improvements in blood pressure and the structure and function of the heart, and reductions in obstructive sleep apnoea and diabetes.
Weight and impact on heart rhythm was followed in more than 350 obese patients with atrial fibrillation, with researchers tracking their health annually for an average of four years. To encourage weight loss, the patients' clinic used a motivational, goal-directed approach that initially included in-person visits every three months, detailed dietary guidance, low-intensity exercise, counseling support, and a daily diet and physical activity diary.
After an average of four years, 45% of patients who lost 10% or more of their body weight, and 22% of patients who lost 3-9% of their weight, achieved freedom from atrial fibrillation symptoms without the use of any atrial fibrillation surgery or medication.
"Even with the use of surgery or medication, those who lost more weight were substantially more likely to be cured of atrial fibrillation," Pathak says.
[link url="http://www.adelaide.edu.au/news/news76842.html"]University of Adelaide material[/link]
[link url="http://content.onlinejacc.org/article.aspx?articleID=2196400"]Journal of the American College of Cardiology abstract[/link]