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Effect of Weight Reduction and Cardiometabolic Risk Factor Management on Symptom Burden and Severity in Patients With Atrial Fibrillation: A Randomized Clinical Trial
Abstract
IMPORTANCE: 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. OBJECTIVE: To determine the effect of weight reduction and management of cardiometabolic risk factors on atrial fibrillation burden and cardiac structure. DESIGN, SETTING, AND PATIENTS: 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. INTERVENTIONS: Patients were randomized to weight management (intervention) or general lifestyle advice (control). Both groups underwent intensive management of cardiometabolic risk factors. MAIN OUTCOMES AND MEASURES: 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. RESULTS: 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). CONCLUSIONS AND RELEVANCE: 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. TRIAL REGISTRATION: anzctr.org.au Identifier: ACTRN12610000497000.
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“Although there is ample evidence that weight loss and maintaining an ideal weight are beneficial in reducing AF burden and symptoms, compliance with this recommendation is poor; the reasons include among others the inability to track food intake (Abed 2013, Donnellan 2019, Pathak 2015).”
From 2021 ISHNE/HRS/EHRA/APHRS Expert Collaborative Statement on mHealth in Arrhythmia Management: Digital Medical Tools for Heart Rhythm Professionals: From the International Society for Holter and Noninvasive Electrocardiology/Heart Rhythm Society/European Heart Rhythm Association/Asia-Pacific Heart Rhythm Society (2021) · cites this paper as Abed 2013
In the citing paper
“Intensive weight-reduction management in addition to management of other cardiovascular risk factors (in the range of 10-15 kg weight loss achieved) led to fewer AF recurrences and symptoms compared with an approach based on general advice in obese patients with AF.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [204]
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Cites
Grundy, S. M., Bilheimer, D. W., Chait, A., Clark, L. T., Denke, M. A., Havel, R. J., Hazzard, W. R., Hulley, S. B., Hunninghake, D. B., Kreisberg, R. A., et al. (1993) · JAMA · doi:10.1001/jama.269.23.3015 · Cited by 27,944
Detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III)
Grundy, S. M., Becker, D. M., Clark, L. T., Cooper, R., Denke, M. A., Howard, J. L., Hunninghake, D. B., Illingworth, D. R., Luepker, R. V., McBride, P. E., et al. (2002) · Civil War Book Review · Cited by 12,198
Lang, R. M., Bierig, M., Devereux, R. B., Flachskampf, F. A., Foster, E., Pellikka, P. A., Picard, M. H., Roman, M. J., Seward, J., Shanewise, J. S., et al. (2005) · Journal of the American Society of Echocardiography · doi:10.1016/j.echo.2005.10.005 · Cited by 11,318
Impact of Atrial Fibrillation on the Risk of Death: The Framingham Heart Study
Benjamin, E. J., Wolf, P. A., D’Agostino, R. B., Silbershatz, H., Kannel, W. B., & Levy, D. (1998) · Circulation · doi:10.1161/01.cir.98.10.946 · Cited by 4,575
McNicholas, W. T., Strohl, K. P., White, D. P., Levy, P. A., Schmidt, W., Wheatley, J. R., Redline, S. S., Carley, D. W., Buysse, D. J., Young, T. B., et al. (1999) · PubMed · Cited by 3,665
Benjamin, E. J. (1994) · JAMA · doi:10.1001/jama.1994.03510350050036 · Cited by 2,613
Miyasaka, Y., Barnes, M. E., Gersh, B. J., Cha, S. S., Bailey, K. R., Abhayaratna, W. P., Seward, J. B., & Tsang, T. S. M. (2006) · Circulation · doi:10.1161/circulationaha.105.595140 · Cited by 2,564
Elevated C-reactive protein levels in overweight and obese adults
Visser, M. (1999) · JAMA · doi:10.1001/jama.282.22.2131 · Cited by 2,494
Kannel, W. B., Wolf, P. A., Benjamin, E. J., & Levy, D. (1998) · The American Journal of Cardiology · doi:10.1016/s0002-9149(98)00583-9 · Cited by 2,033
Obesity and the risk of new-onset atrial fibrillation
Wang, T. J. (2004) · JAMA · doi:10.1001/jama.292.20.2471 · Cited by 1,427
Cardiovascular Medicine at the Turn of the Millennium: Triumphs, Concerns, and Opportunities
Braunwald, E. (1997) · New England Journal of Medicine · doi:10.1056/nejm199711063371906 · Cited by 1,426
Atrial Remodeling and Atrial Fibrillation: Mechanisms and Implications
Nattel, S., Burstein, B., & Dobrev, D. (2008) · Circulation: Arrhythmia and Electrophysiology · doi:10.1161/circep.107.754564 · Cited by 1,124
Alcohol Consumption and Blood Pressure
Klatsky, A. L., FRIEDMAN, G. D., SIEGELAUB, A. B., & Gérard, M. J. (1977) · New England Journal of Medicine · doi:10.1056/nejm197705262962103 · Cited by 867
Wachtell, K., Lehto, M., Gerdts, E., Olsen, M. H., Hornestam, B., Dahlöf, B., Ibsen, H., Julius, S., Kjeldsen, S. E., Lindholm, L. H., et al. (2005) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2004.10.068 · Cited by 826
Healey, J. S., Baranchuk, A., Crystal, E., Morillo, C. A., Garfinkle, M., Yusuf, S., & Connolly, S. J. (2005) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2004.11.070 · Cited by 822
Comparative Effectiveness of Weight-Loss Interventions in Clinical Practice
Appel, L. J., Clark, J. M., Yeh, H.-C., Wang, N.-Y., Coughlin, J. W., Daumit, G., Miller, E. R., Dalcin, A., Jerome, G. J., Geller, S., et al. (2011) · New England Journal of Medicine · doi:10.1056/nejmoa1108660 · Cited by 783
Madrid, A. H., Bueno, M. G., Rebollo, J. M. G., Marín, I., Peña, G., Bernal, E., Rodriguez, A., Cano, L., Cano, J. M., Cabeza, P., et al. (2002) · Circulation · doi:10.1161/01.cir.0000022665.18619.83 · Cited by 685
Dorian, P., Jung, W., Newman, D., Paquette, M., Wood, K., Ayers, G. M., Camm, J., Akhtar, M., & Luderitz, B. (2000) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(00)00886-x · Cited by 627
The Long- and Short-Term Impact of Elevated Body Mass Index on the Risk of New Atrial Fibrillation
Tedrow, U. B., Conen, D., Ridker, P. M., Cook, N. R., Koplan, B. A., Manson, J. E., Buring, J. E., & Albert, C. M. (2010) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.02.029 · Cited by 500
Pericardial Fat Is Associated With Atrial Fibrillation Severity and Ablation Outcome
Wong, C. X. J., Abed, H. S., Molaee, P., Nelson, A. J., Brooks, A. G., Sharma, G., Leong, D. P., Lau, D. H., Middeldorp, M. E., Roberts‐Thomson, K. C., et al. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.11.045 · Cited by 494
Atrial fibrillation and obesity—results of a meta-analysis
Wanahita, N., Messerli, F. H., Bangalore, S., Gami, A. S., Somers, V. K., & Steinberg, J. S. (2008) · American Heart Journal · doi:10.1016/j.ahj.2007.10.004 · Cited by 474
Valsartan for prevention of recurrent atrial fibrillation
(2009) · New England Journal of Medicine · doi:10.1056/nejmoa0805710 · Cited by 441
Assessing the Direct Costs of Treating Nonvalvular Atrial Fibrillation in the United States
Coyne, K. S., Paramore, C., Grandy, S., Mercader, M. A., Reynolds, M. W., & ZIMETBAUM, P. J. (2006) · Value in Health · doi:10.1111/j.1524-4733.2006.00124.x · Cited by 422
Heart rate variability in obesity and the effect of weight loss
Karason, K., Mølgaard, H., Wikstrand, J., & Sjöström, L. (1999) · The American Journal of Cardiology · doi:10.1016/s0002-9149(99)00066-1 · Cited by 402
Abed, H. S., Samuel, C. S., Lau, D. H., Kelly, D. J., Royce, S. G., Alasady, M., Mahajan, R., Kuklik, P., Zhang, Y., Brooks, A. G., et al. (2012) · Heart Rhythm · doi:10.1016/j.hrthm.2012.08.043 · Cited by 401
Effect of Obesity and Overweight on Left Ventricular Diastolic Function
Russo, C., Jin, Z., Homma, S., Rundek, T., Elkind, M. S. V., Sacco, R. L., & Di Tullio, M. R. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.10.042 · Cited by 361
Valsartan for Prevention of Recurrent Atrial Fibrillation
Modena, M. G. (2009) · New England Journal of Medicine · doi:10.1056/nejmx090019 · Cited by 328
Atrial remodeling in obstructive sleep apnea: Implications for atrial fibrillation
Dimitri, H. R., Ng, M., Brooks, A. G., Kuklik, P., Stiles, M. K., Lau, D. H., Antic, N. A., Thornton, A., Saint, D. A., McEvoy, R. D., et al. (2011) · Heart Rhythm · doi:10.1016/j.hrthm.2011.10.017 · Cited by 325
Tsang, T. S. M., Barnes, M. E., Miyasaka, Y., Cha, S. S., Bailey, K. R., Verzosa, G., Seward, J. B., & Gersh, B. J. (2008) · European Heart Journal · doi:10.1093/eurheartj/ehn324 · Cited by 313
Alcohol Consumption and Risk of Atrial Fibrillation
Kodama, S., Saito, K., Tanaka, S., Horikawa, C., Saito, A., Heianza, Y., Anasako, Y., Nishigaki, Y., Yachi, Y., Iida, K., et al. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2010.08.641 · Cited by 303
Singh, S. N., Tang, X. C., Singh, B. N., Dorian, P., Reda, D. J., Harris, C. L., Fletcher, R. D., Sharma, S. C., Atwood, J. E., Jacobson, A. K., et al. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.03.051 · Cited by 231
Stritzke, J., Markus, M. R. P., Duderstadt, S., Lieb, W., Luchner, A., Döring, A., Keil, U., Hense, H., & Schunkert, H. (2009) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2009.07.034 · Cited by 205
Effect of Single-Drug Therapy on Reduction of Left Atrial Size in Mild to Moderate Hypertension
Gottdiener, J. S., Reda, D. J., Williams, D. W., Materson, B. J., Cushman, W. G., & Anderson, R. J. (1998) · Circulation · doi:10.1161/01.cir.98.2.140 · Cited by 203
Munger, T. M., Dong, Y.-X., Masaki, M., Oh, J. K., Mankad, S. V., Borlaug, B. A., Asirvatham, S. J., Shen, W.-K., Lee, H.-C., Bielinski, S. J., et al. (2012) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2012.03.042 · Cited by 190
Mechanisms for increased myocardial fatty acid utilization following short-term high-fat feeding
Wright, J. J., Kim, J., Buchanan, J., Boudina, S., Sena, S., Bakirtzi, K., Ilkun, O. L., Theobald, H. A., Cooksey, R. C., Kandror, K. V., et al. (2009) · Cardiovascular Research · doi:10.1093/cvr/cvp017 · Cited by 179
Elobeid, M. A., Padilla, M. A., McVie, T., Thomas, O., Brock, D. W., Musser, B., Lu, K., Coffey, C. S., Desmond, R. A., St-Onge, M.-P., et al. (2009) · PLoS ONE · doi:10.1371/journal.pone.0006624 · Cited by 158
Long-Term Persistence of Hormonal Adaptations to Weight Loss
Sumithran, P., Prendergast, L. A., Delbridge, E., Purcell, K., Shulkes, A., Kriketos, A. D., & Proietto, J. (2012) · Obstetrical & Gynecological Survey · doi:10.1097/ogx.0b013e318247c6f7 · Cited by 134
Effects of a low-energy diet on sexual function and lower urinary tract symptoms in obese men
Khoo, J. J. C., Piantadosi, C., Worthley, S. G., & Wittert, G. (2010) · International Journal of Obesity · doi:10.1038/ijo.2010.76 · Cited by 121
Pena, J. M., MacFadyen, J. G., Glynn, R., & Ridker, P. M. (2011) · European Heart Journal · doi:10.1093/eurheartj/ehr460 · Cited by 115
Wachtell, K., Lehto, M., & Gerdts, E. (2005) · ACC Current Journal Review · doi:10.1016/j.accreview.2005.05.064 · Cited by 79
MARCUS, G. M., SMITH, L. M., WHITEMAN, D., TSENG, Z. H., BADHWAR, N., LEE, B. K., LEE, R. J., SCHEINMAN, M. M., & OLGIN, J. E. (2008) · Pacing and Clinical Electrophysiology · doi:10.1111/j.1540-8159.2008.00985.x · Cited by 75
Healey, J., Baranchuk, A., & Crystal, E. (2005) · ACC Current Journal Review · doi:10.1016/j.accreview.2005.08.243 · Cited by 72
Insulin Resistance and Atrial Fibrillation (from the Framingham Heart Study)
Fontes, J. D., Lyass, A., Massaro, J. M., Rienstra, M., Dallmeier, D., Schnabel, R. B., Wang, T. J., Vasan, R. S., Lubitz, S. A., Magnani, J. W., et al. (2011) · The American Journal of Cardiology · doi:10.1016/j.amjcard.2011.08.008 · Cited by 68
Wachtell, K., Gerdts, E., Aurigemma, G. P., Boman, K., Dahlöf, B., Nieminen, M. S., Olsen, M. H., Okin, P. M., Palmieri, V., Rokkedal, J. E., et al. (2010) · Blood Pressure · doi:10.3109/08037051.2010.481811 · Cited by 67
Madrid, A. H., Bueno, M. G., & Rebollo, J. M. G. (2002) · ACC Current Journal Review · doi:10.1016/s1062-1458(02)00954-6 · Cited by 51
Long-term persistence of hormonal adaptations to weight loss
Sumithran, P., Prendergast, L. A., Delbridge, E., Purcell, K., Shulkes, A., & Proietto, J. (2011) · Obesity Research & Clinical Practice · doi:10.1016/j.orcp.2011.08.082 · Cited by 42
Obesity and the Risk of New-Onset Atrial Fibrillation
Parish, D. (2005) · JAMA · doi:10.1001/jama.293.16.1974-b · Cited by 36
Cocco, G., & Pandolfi, S. (2011) · The Journal of Clinical Hypertension · doi:10.1111/j.1751-7176.2010.00380.x · Cited by 32
Comparative Effectiveness of Weight-Loss Interventions in Clinical Practice
Ness-Abramof, R. (2012) · Yearbook of Medicine · doi:10.1016/s0084-3873(12)00319-7 · Cited by 19
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Metadata
- Authors
- Abed, H. S., Wittert, G. A., Leong, D. P., Shirazi, M. G., Bahrami, B., Middeldorp, M. E., Lorimer, M. F., Lau, D. H., Antic, N. A., Brooks, A. G., Abhayaratna, W. P., Kalman, J. M., & Sanders, P.
- Affiliations
- Royal Adelaide Hospital (AU)
- The University of Adelaide (AU)
- Repatriation General Hospital (AU)
- Australian National University (AU)
- The Royal Melbourne Hospital (AU)
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2013-11-20
- Volume
- 310
- Issue
- 19
- Pages
- 2050
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W1963940525
- Cited by
- 776
- References
- 52
- Citations by year
- 2026: 51 · 2025: 64 · 2024: 69 · 2023: 53 · 2022: 56 · 2021: 76 · 2020: 50 · 2019: 70 · 2018: 52 · 2017: 81 · 2016: 63 · 2015: 51 · 2014: 35 · 2013: 4
- FWCI
- 34.64
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Flinders Academic Commons (Flinders University) (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Flinders Academic Commons (Flinders University) (submittedVersion)
- ANU Open Research (Australian National University) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Keywords
- weight loss, obesity, cardiometabolic risk factors, symptom burden, symptom severity, cardiac remodeling, left atrial area, interventricular septum thickness, lifestyle intervention, overweight patients, Holter monitoring, cardiac structure, risk factor control, weight management, lifestyle advice
- MeSH terms
- Aged, Atrial Fibrillation, Diet, Reducing, Echocardiography, Fish Oils, Heart Atria, Humans, Life Style, Male, Middle Aged, Obesity, Risk Factors, Severity of Illness Index, Weight Loss, Treatment Outcome, Overweight
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