Compliance in weight control reduces atrial fibrillation worsening: a retrospective cohort study

• Published in: Nutrition, metabolism, and cardiovascular diseases metabolism, and cardiovascular diseases, 2017-08, Vol.27 (8), p.711-716
• Main Authors: Fioravanti, F, Brisinda, D, Sorbo, A.R, Lombardi, G, La Brocca, L, Fenici, R
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Arrhythmia; Atrial fibrillation; Atrial Fibrillation - diagnosis; Atrial Fibrillation - etiology; Atrial Fibrillation - physiopathology; Atrial Fibrillation - prevention & control; BMI; Body Mass Index; Cardiovascular; Comorbidity; Disease Progression; Disease-Free Survival; Female; Heart Rate; Humans; Male; Middle Aged; Obesity; Obesity - complications; Obesity - diagnosis; Obesity - physiopathology; Obesity - therapy; Recurrence; Retrospective Studies; Risk Assessment; Risk Factors; Risk Reduction Behavior; Time Factors; Treatment Outcome; Weight Loss
• ISSN: 0939-4753; 1590-3729
• DOI: 10.1016/j.numecd.2017.04.007

Abstract Background and Aim Obesity plays a dominant role in the etiology of Atrial Fibrillation (AF) and the maintenance of a normal BMI seems preventing and even reducing the incidence of the arrhythmia’s recurrence. We selected 270 patients (pts) to assess whether this therapeutic effect was statistically significant even in Mediterranean patients. Method and Results In this retrospective cohort study, we analyzed every symptomatic AF-relapse during a total follow-up of 657 patient-years. Clinical data, BMI variations and pts’ history were all available in our clinical database. We divided the pts in four groups (Gs), according to their BMI variation during the follow-up: G1, normal weight pts, maintaining their weight; G2, overweight pts, losing weight; G3, overweight pts, maintaining their weight; G4, pts gaining weight. Their follow-up (in months) was normalized on their AF relapses, obtaining a mean AF-free period for every patient. Among the overweight groups, G2 showed the best AF-free period (9.7 months). However, G3 and G4 showed a reduced AF-free interval (4.6 and 1.7 months, respectively). G1, predictably, had the longest AF-free period (10 months). Conclusion The results of the present study confirm that simple non-invasive intervention aimed to normalize BMI and to control risk factors through appropriate lifestyle can be highly effective in reducing the atrial fibrillation burden, by acting on comorbidities and proarrhythmic mechanisms. Therefore serious attempt should be done to correct risk factors before an ablation therapy is proposed.