Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation a randomized clinical trial

Simple item page
dc.contributor.authorAbed, H.
dc.contributor.authorWittert, G.
dc.contributor.authorLeong, D.
dc.contributor.authorShirazi, M.
dc.contributor.authorBahrami, B.
dc.contributor.authorMiddeldorp, M.
dc.contributor.authorLorimer, M.
dc.contributor.authorLau, D.
dc.contributor.authorAntic, N.
dc.contributor.authorBrooks, A.
dc.contributor.authorAbhayaratna, W.
dc.contributor.authorKalman, J.
dc.contributor.authorSanders, P.
dc.date.issued2013
dc.description.abstract<h4>Importance</h4>Obesity is a risk factor for atrial fibrillation. Whether weight reduction and cardiometabolic risk factor management can reduce the burden of atrial fibrillation is not known.<h4>Objective</h4>To determine the effect of weight reduction and management of cardiometabolic risk factors on atrial fibrillation burden and cardiac structure.<h4>Design, setting, and patients</h4>Single-center, partially blinded, randomized controlled study conducted between June 2010 and December 2011 in Adelaide, Australia, among overweight and obese ambulatory patients (N = 150) with symptomatic atrial fibrillation. Patients underwent a median of 15 months of follow-up.<h4>Interventions</h4>Patients were randomized to weight management (intervention) or general lifestyle advice (control). Both groups underwent intensive management of cardiometabolic risk factors.<h4>Main outcomes and measures</h4>The primary outcomes were Atrial Fibrillation Severity Scale scores: symptom burden and symptom severity. Scores were measured every 3 months from baseline to 15 months. Secondary outcomes performed at baseline and 12 months were total atrial fibrillation episodes and cumulative duration measured by 7-day Holter, echocardiographic left atrial area, and interventricular septal thickness.<h4>Results</h4>Of 248 patients screened, 150 were randomized (75 per group) and underwent follow-up. The intervention group showed a significantly greater reduction, compared with the control group, in weight (14.3 and 3.6 kg, respectively; P < .001) and in atrial fibrillation symptom burden scores (11.8 and 2.6 points, P < .001), symptom severity scores (8.4 and 1.7 points, P < .001), number of episodes (2.5 and no change, P = .01), and cumulative duration (692-minute decline and 419-minute increase, P = .002). Additionally, there was a reduction in interventricular 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).<h4>Conclusions and relevance</h4>In this study, weight reduction with intensive risk factor management resulted in a reduction in atrial fibrillation symptom burden and severity and in beneficial cardiac remodeling. These findings support therapy directed at weight and risk factors in the management of atrial fibrillation.<h4>Trial registration</h4>anzctr.org.au Identifier: ACTRN12610000497000.
dc.description.statementofresponsibilityHany S. Abed, Gary A. Wittert, Darryl P. Leong, Masoumeh G. Shirazi, Bobak Bahrami, Melissa E. Middeldorp Michelle F. Lorimer, Dennis H. Lau, Nicholas A. Antic, Anthony G. Brooks, Walter P. Abhayaratna, Jonathan M. Kalman, Prashanthan Sanders
dc.identifier.citationJournal of the American Medical Association (JAMA), 2013; 310(19):2050-2060
dc.identifier.doi10.1001/jama.2013.280521
dc.identifier.issn0098-7484
dc.identifier.issn1538-3598
dc.identifier.orcidWittert, G. [0000-0001-6818-6065]
dc.identifier.orcidBahrami, B. [0000-0003-1057-5142]
dc.identifier.orcidMiddeldorp, M. [0000-0002-4106-9771]
dc.identifier.orcidLorimer, M. [0000-0003-3785-4395]
dc.identifier.orcidLau, D. [0000-0001-7753-1318] [0000-0002-1564-439X]
dc.identifier.orcidSanders, P. [0000-0003-3803-8429]
dc.identifier.urihttp://hdl.handle.net/2440/82673
dc.language.isoen
dc.publisherAmer Medical Assoc
dc.rights© 2013 American Medical Association. All Rights Reserved.
dc.source.urihttps://doi.org/10.1001/jama.2013.280521
dc.subjectHeart Atria
dc.subjectHumans
dc.subjectAtrial Fibrillation
dc.subjectObesity
dc.subjectWeight Loss
dc.subjectFish Oils
dc.subjectEchocardiography
dc.subjectTreatment Outcome
dc.subjectDiet, Reducing
dc.subjectSeverity of Illness Index
dc.subjectRisk Factors
dc.subjectLife Style
dc.subjectAged
dc.subjectMiddle Aged
dc.subjectMale
dc.subjectOverweight
dc.titleEffect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation a randomized clinical trial
dc.typeJournal article
pubs.publication-statusPublished

Files

Collections

Medicine publications