Weight reduction decreases atrial fibrillation and symptom severity

Hany S. Abed, B.Pharm., M.B.B.S., of the University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia and colleagues evaluated the effect of a structured weight reduction program on atrial fibrillation symptoms.

"Atrial fibrillation has been described as the epidemic of the new millennium, with a projection that by 2050 there will be 12 million to 15 million affected individuals in the United States. In the United States, the direct economic cost of atrial fibrillation is estimated at $6 billion annually. Although population aging is regarded as an important contributor, obesity may account for a substantial proportion of the increasing prevalence," according to background information in the article. Whether and cardiometabolic risk factor management can reduce the burden of atrial fibrillation has not been known.

The study was conducted between June 2010 and December 2011 among overweight and obese patients with symptomatic atrial fibrillation. Patients underwent a median (midpoint) of 15 months of follow-up. Patients were randomized to weight management (intervention; n = 75) or general lifestyle advice (control; n = 75). Both groups underwent intensive management of cardiometabolic risk factors (hypertension, hyperlipidemia, glucose intolerance, sleep apnea, and alcohol and tobacco use).

The intervention group experienced greater reduction, compared with the control group, in weight (33 and 12.5 lbs., respectively,) and in atrial fibrillation, symptom severity, number of episodes, and cumulative duration in minutes.

"In this study, a structured weight management program for highly symptomatic patients with reduced symptom burden and severity and reduced antiarrhythmic use when compared with attempts to optimally manage risk factors alone," the authors write.

More information: JAMA doi:10.l001/jama.2013.280521

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