Melissa E Middeldorp1, Rajeev K Pathak1, Megan Meredith1, Abhinav B Mehta2, Adrian D Elliott1, Rajiv Mahajan1, Darragh Twomey1, Celine Gallagher1, Jeroen M L Hendriks1, Dominik Linz1, R Doug McEvoy3, Walter P Abhayaratna4, Jonathan M Kalman5, Dennis H Lau1, Prashanthan Sanders1. 1. Centre for Heart Rhythm Disorders (CHRD), South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia. 2. Research School of Finance, Actuarial Studies and Applied Statistics, Australian National University, Canberra, Australia. 3. Adelaide Institute for Sleep Health, Flinders University and Sleep Health Service, Respiratory and Sleep Services, Southern Adelaide Local Health Network, Adelaide, Australia. 4. College of Medicine, Biology and Environment, Australian National University and Canberra Hospital, Canberra, Australia. 5. Department of Cardiology, Royal Melbourne Hospital and Department of Medicine, University of Melbourne, Melbourne, Australia.
Abstract
Aims: Atrial fibrillation (AF) is a progressive disease. Obesity is associated with progression of AF. This study evaluates the impact of weight and risk factor management (RFM) on progression of the AF. Methods and results: As described in the Long-Term Effect of Goal-Directed Weight Management in an Atrial Fibrillation Cohort: A Long-Term Follow-Up (LEGACY) Study, of 1415 consecutive AF patients, 825 had body mass index ≥ 27 kg/m2 and were offered weight and RFM. After exclusion, 355 were included for analysis. Weight loss was categorized as: Group 1 (<3%), Group 2 (3-9%), and Group 3 (≥10%). Change in AF type was determined by clinical review and 7-day Holter yearly. Atrial fibrillation type was categorized as per the Heart Rhythm Society consensus. There were no differences in baseline characteristic or follow-up duration between groups (P = NS). In Group 1, 41% progressed from paroxysmal to persistent and 26% from persistent to paroxysmal or no AF. In Group 2, 32% progressed from paroxysmal to persistent and 49% reversed from persistent to paroxysmal or no AF. In Group 3, 3% progressed to persistent and 88% reversed from persistent to paroxysmal or no AF (P < 0.001). Increased weight loss was significantly associated with greater AF freedom: 45 (39%) in Group 1, 69 (67%) in Group 2, and 116 (86%) in Group 3 (P ≤ 0.001). Conclusion: Obesity is associated with progression of the AF disease. This study demonstrates the dynamic relationship between weight/risk factors and AF. Weight-loss management and RFM reverses the type and natural progression of AF.
Aims: Atrial fibrillation (AF) is a progressive disease. Obesity is associated with progression of AF. This study evaluates the impact of weight and risk factor management (RFM) on progression of the AF. Methods and results: As described in the Long-Term Effect of Goal-Directed Weight Management in an Atrial Fibrillation Cohort: A Long-Term Follow-Up (LEGACY) Study, of 1415 consecutive AFpatients, 825 had body mass index ≥ 27 kg/m2 and were offered weight and RFM. After exclusion, 355 were included for analysis. Weight loss was categorized as: Group 1 (<3%), Group 2 (3-9%), and Group 3 (≥10%). Change in AF type was determined by clinical review and 7-day Holter yearly. Atrial fibrillation type was categorized as per the Heart Rhythm Society consensus. There were no differences in baseline characteristic or follow-up duration between groups (P = NS). In Group 1, 41% progressed from paroxysmal to persistent and 26% from persistent to paroxysmal or no AF. In Group 2, 32% progressed from paroxysmal to persistent and 49% reversed from persistent to paroxysmal or no AF. In Group 3, 3% progressed to persistent and 88% reversed from persistent to paroxysmal or no AF (P < 0.001). Increased weight loss was significantly associated with greater AF freedom: 45 (39%) in Group 1, 69 (67%) in Group 2, and 116 (86%) in Group 3 (P ≤ 0.001). Conclusion: Obesity is associated with progression of the AF disease. This study demonstrates the dynamic relationship between weight/risk factors and AF. Weight-loss management and RFM reverses the type and natural progression of AF.
Authors: Toshimasa Okabe; Benjamin Buck; Samuel A Hayes; Thura T Harfi; Muhammad R Afzal; Jaret Tyler; Mahmoud Houmsse; Steven J Kalbfleisch; Raul Weiss; John D Hummel; Ralph S Augostini; Emile G Daoud Journal: J Atr Fibrillation Date: 2020-04-30
Authors: Jens Cosedis Nielsen; Yenn-Jiang Lin; Marcio Jansen de Oliveira Figueiredo; Alireza Sepehri Shamloo; Alberto Alfie; Serge Boveda; Nikolaos Dagres; Dario Di Toro; Lee L Eckhardt; Kenneth Ellenbogen; Carina Hardy; Takanori Ikeda; Aparna Jaswal; Elizabeth Kaufman; Andrew Krahn; Kengo Kusano; Valentina Kutyifa; Han S Lim; Gregory Y H Lip; Santiago Nava-Townsend; Hui-Nam Pak; Gerardo Rodríguez Diez; William Sauer; Anil Saxena; Jesper Hastrup Svendsen; Diego Vanegas; Marmar Vaseghi; Arthur Wilde; T Jared Bunch; Alfred E Buxton; Gonzalo Calvimontes; Tze-Fan Chao; Lars Eckardt; Heidi Estner; Anne M Gillis; Rodrigo Isa; Josef Kautzner; Philippe Maury; Joshua D Moss; Gi-Byung Nam; Brian Olshansky; Luis Fernando Pava Molano; Mauricio Pimentel; Mukund Prabhu; Wendy S Tzou; Philipp Sommer; Janice Swampillai; Alejandro Vidal; Thomas Deneke; Gerhard Hindricks; Christophe Leclercq Journal: Europace Date: 2020-08-01 Impact factor: 5.214
Authors: Tiffany M Powell-Wiley; Paul Poirier; Lora E Burke; Jean-Pierre Després; Penny Gordon-Larsen; Carl J Lavie; Scott A Lear; Chiadi E Ndumele; Ian J Neeland; Prashanthan Sanders; Marie-Pierre St-Onge Journal: Circulation Date: 2021-04-22 Impact factor: 29.690
Authors: Larry Scott; Anke C Fender; Arnela Saljic; Luge Li; Xiaohui Chen; Xiaolei Wang; Dominik Linz; Jilu Lang; Mathias Hohl; Darragh Twomey; Thuy T Pham; Rodrigo Diaz-Lankenau; Mihail G Chelu; Markus Kamler; Mark L Entman; George E Taffet; Prashanthan Sanders; Dobromir Dobrev; Na Li Journal: Cardiovasc Res Date: 2021-06-16 Impact factor: 10.787
Authors: Omar M Aldaas; Florentino Lupercio; Frederick T Han; Kurt S Hoffmayer; David Krummen; Gordon Ho; Farshad Raissi; Ulrika Birgersdotter-Green; Gregory K Feld; Jonathan C Hsu Journal: Am J Cardiol Date: 2019-08-22 Impact factor: 2.778