Abstract
Abed and colleagues (JAMA. 2013 Nov 20; 310 (19):2050-60; PMID: 24240932) evaluated the effect of weight reduction on atrial fibrillation (AF) burden and cardiac structure in a randomized controlled trial. Obese patients with symptomatic AF (150) were randomized to weight management (intervention) or general lifestyle advice (control). The primary outcomes were AF Severity Scale scores, symptom burden, and symptom severity. Secondary outcomes were AF episodes and AF duration, left atrial area, and septal thickness. The intervention group showed a significantly greater reduction in weight (14.3 and 3.6 kg, respectively; P < .001) and in AF symptom burden scores (11.8 and 2.6 points, P < .001), symptom severity scores (8.4 and 1.7 points, P < .001), and cumulative AF duration (692-minute decline and 419-minute increase, P = .002). There was a reduction in septal thickness in the intervention and control groups (1.1 and 0.6 mm, P = .02) and left atrial area (3.5 and 1.9 cm2, P = .02). The authors conclude weight reduction with intensive risk factor management reduces AF symptom burden and severity and in beneficial cardiac remodeling.
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