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Effect of weight loss on recurrence of atrial fibrillation after ablative therapy: a systematic review and meta-analysis

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Journal of Interventional Cardiac Electrophysiology Aims and scope Submit manuscript

Abstract

Background

Landmark trials have shown superiority of ablative therapy over medical therapy in certain subpopulation with atrial fibrillation (AF). Previous studies have demonstrated an association between weight loss and reduced rates of recurrence of AF after ablation. The objective of this study is to determine if weight loss reduces the recurrence of AF after ablation.

Methods

An extensive literature search and systematic review of studies of weight loss on recurrence of AF after ablative therapy was performed. Risk ratio (RR) and 95% confidence intervals were measured for weight loss group versus control group in each study, and comparative analysis as well as subgroup analysis was made.

Results

Eight studies with a total of 1,425 patients were included. Overall, studies of patients who lost weight demonstrated lower recurrence of AF (RR 0.35; 95% CI 0.18–0.67). However, subgroup analysis of studies which included patients who lost ≥10% weight loss from baseline showed lower recurrence of AF (RR 0.18; 95% 0.03–0.89), whereas studies which included patients with <10% weight loss did not (RR 1.00; 95% 0.51–1.96). Studies of patients who had less than 12-month history of AF (RR 0.24; 95% CI 0.11–0.57) and those who lost weight prior to ablation (RR 0.40; 95% CI 0.20–0.79) also had lower recurrence of AF.

Conclusion

Weight loss is associated with lower long-term recurrence of AF after ablative therapy. Studies of patients with ≥10% weight loss, less than 12-month history of AF, and weight loss prior to ablation experience lower recurrence of AF.

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References

  1. Krijthe BP, et al. Projections on the number of individuals with atrial fibrillation in the European Union, from 2000 to 2060. Eur Heart J. 2013;34(35):2746–51.

    Article  Google Scholar 

  2. Piccini JP, et al. Incidence and prevalence of atrial fibrillation and associated mortality among Medicare beneficiaries, 1993-2007. Circ Cardiovasc Qual Outcomes. 2012;5(1):85–93.

    Article  Google Scholar 

  3. Chugh SS, et al. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation. 2014;129(8):837–47.

    Article  Google Scholar 

  4. Colilla S, et al. Estimates of current and future incidence and prevalence of atrial fibrillation in the U.S. adult population. Am J Cardiol. 2013;112(8):1142–7.

    Article  Google Scholar 

  5. Di Biase L, et al. Ablation versus amiodarone for treatment of persistent atrial fibrillation in patients with congestive heart failure and an implanted device: results from the AATAC multicenter randomized trial. Circulation. 2016;133(17):1637–44.

    Article  Google Scholar 

  6. Brachmann J, et al. Atrial fibrillation burden and clinical outcomes in heart failure: The CASTLE-AF Trial. JACC Clin Electrophysiol. 2021;7(5):594–603.

    Article  Google Scholar 

  7. Kirchhof P, et al. Early rhythm-control therapy in patients with atrial fibrillation. N Engl J Med. 2020;383(14):1305–16.

    Article  Google Scholar 

  8. Aldaas OM, et al. Meta-analysis of effect of modest (>/=10%) weight loss in management of overweight and obese patients with atrial fibrillation. Am J Cardiol. 2019;124(10):1568–74.

    Article  Google Scholar 

  9. Page MJ, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Bmj. 2021;372:n71.

    Article  Google Scholar 

  10. Mohanty S, et al. Impact of weight loss on ablation outcome in obese patients with longstanding persistent atrial fibrillation. J Cardiovasc Electrophysiol. 2018;29(2):246–53.

    Article  Google Scholar 

  11. Pathak RK, et al. Aggressive risk factor reduction study for atrial fibrillation and implications for the outcome of ablation: the ARREST-AF cohort study. J Am Coll Cardiol. 2014;64(21):2222–31.

    Article  Google Scholar 

  12. Yew Ding W, et al. Feasibility of weight loss in obese atrial fibrillation patients attending a specialist arrhythmia clinic and its impact on ablation outcomes. J Arrhythm. 2020;36(6):984–90.

    Article  Google Scholar 

  13. Donnellan E, et al. Impact of risk-factor modification on arrhythmia recurrence among morbidly obese patients undergoing atrial fibrillation ablation. J Cardiovasc Electrophysiol. 2020;31(8):1979–86.

    Article  Google Scholar 

  14. Peigh G, et al. Impact of pre-ablation weight loss on the success of catheter ablation for atrial fibrillation. J Cardiovasc Electrophysiol. 2021;32(8):2097–104.

    Article  Google Scholar 

  15. Donnellan E, et al. Association between pre-ablation bariatric surgery and atrial fibrillation recurrence in morbidly obese patients undergoing atrial fibrillation ablation. Europace. 2019;21(10):1476–83.

    Article  Google Scholar 

  16. Gessler N, et al. Supervised obesity reduction trial for AF ablation patients: results from the SORT-AF trial. Europace. 2021.

  17. Yaeger A, et al. Impact of a nurse-led limited risk factor modification program on arrhythmia outcomes in patients with atrial fibrillation undergoing catheter ablation. J Cardiovasc Electrophysiol. 2020;31(2):423–31.

    Article  Google Scholar 

  18. Wang TJ, et al. Obesity and the risk of new-onset atrial fibrillation. JAMA. 2004;292(20):2471–7.

    Article  CAS  Google Scholar 

  19. Frost L, Hune LJ, Vestergaard P. Overweight and obesity as risk factors for atrial fibrillation or flutter: the Danish Diet, Cancer, and Health Study. Am J Med. 2005;118(5):489–95.

    Article  Google Scholar 

  20. Foy AJ, et al. Relation of obesity to new-onset atrial fibrillation and atrial flutter in adults. Am J Cardiol. 2018;121(9):1072–5.

    Article  Google Scholar 

  21. Berkovitch A, et al. Body mass index and the risk of new-onset atrial fibrillation in middle-aged adults. Am Heart J. 2016;173:41–8.

    Article  Google Scholar 

  22. Lee H, et al. Atrial fibrillation risk in metabolically healthy obesity: a nationwide population-based study. Int J Cardiol. 2017;240:221–7.

    Article  Google Scholar 

  23. Abed HS, et al. Obesity results in progressive atrial structural and electrical remodeling: implications for atrial fibrillation. Heart Rhythm. 2013;10(1):90–100.

    Article  Google Scholar 

  24. Mahajan R, et al. Electrophysiological, electroanatomical, and structural remodeling of the atria as consequences of sustained obesity. J Am Coll Cardiol. 2015;66(1):1–11.

    Article  CAS  Google Scholar 

  25. Middeldorp ME, et al. PREVEntion and regReSsive Effect of weight-loss and risk factor modification on atrial fibrillation: the REVERSE-AF study. Europace. 2018;20(12):1929–35.

    Article  Google Scholar 

  26. Abed HS, et al. Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: a randomized clinical trial. Jama. 2013;310(19):2050–60.

    Article  CAS  Google Scholar 

  27. Al-Kaisey AM, Parameswaran R, Kalman JM. Atrial fibrillation structural substrates: aetiology, identification and implications. Arrhythm Electrophysiol Rev. 2020;9(3):113–20.

    PubMed  PubMed Central  Google Scholar 

  28. Powell-Wiley TM, et al. Obesity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation. 2021;143(21):e984–e1010.

    Article  Google Scholar 

  29. Balk EM, et al. Predictors of atrial fibrillation recurrence after radiofrequency catheter ablation: a systematic review. J Cardiovasc Electrophysiol. 2010;21(11):1208–16.

    Article  Google Scholar 

  30. Sultan A, et al. Predictors of atrial fibrillation recurrence after catheter ablation: data from the German Ablation Registry. Sci Rep. 2017;7(1):16678.

    Article  CAS  Google Scholar 

  31. Clamp LD, et al. Enhanced insulin sensitivity in successful, long-term weight loss maintainers compared with matched controls with no weight loss history. Nutr Diabetes. 2017;7(6):e282.

    Article  CAS  Google Scholar 

  32. Tsalamandris S, et al. The role of inflammation in diabetes: current concepts and future perspectives. Eur Cardiol. 2019;14(1):50–9.

    Article  Google Scholar 

  33. Nalliah CJ, et al. The role of obesity in atrial fibrillation. Eur Heart J. 2015;37(20):1565–72.

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, John H. Stroger Jr Hospital of Cook County, Chicago, IL, USA

    Dae Yong Park & Mukunthan Murthi

  2. Department of Biomedical Science, Seoul National University Graduate School, Seoul, South Korea

    Seokyung An

  3. Division of Cardiology, Cook County Health, Chicago, IL, USA

    Ajoe John Kattoor & Aviral Vij

  4. Department of Pathology, McGaw Medical Center of Northwestern University, Chicago, IL, USA

    Amandeep Kaur

  5. Warren Clinic Cardiology, Saint Francis Health System, Tulsa, OK, USA

    Venkatesh Ravi

  6. Division of Cardiology, Rush Medical College, Chicago, IL, USA

    Henry D. Huang & Aviral Vij

  7. John H. Stroger Jr Hospital of Cook County, 1901 W. Harrison Street, Suite 3620, Chicago, IL, 60612, USA

    Aviral Vij

Authors
  1. Dae Yong Park
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  2. Seokyung An
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  3. Mukunthan Murthi
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  8. Aviral Vij
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Correspondence to Aviral Vij.

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This study was exempt from ethics approval as only data from previously published studies were retrieved and synthesized.

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The authors declare no competing interests.

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Park, D.Y., An, S., Murthi, M. et al. Effect of weight loss on recurrence of atrial fibrillation after ablative therapy: a systematic review and meta-analysis. J Interv Card Electrophysiol 64, 763–771 (2022). https://doi.org/10.1007/s10840-022-01168-2

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  • DOI: https://doi.org/10.1007/s10840-022-01168-2

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