Cited by 1,036Atrial Fibrillation Management and OutcomesCardiac Arrhythmias and TreatmentsCardiac Health and Mental Health

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Long-Term Effect of Goal-Directed Weight Management in an Atrial Fibrillation Cohort

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Pathak, Rajeev K., Middeldorp, Melissa E., Meredith, Megan, Mehta, Abhinav B., Mahajan, Rajiv, Wong, Christopher X., Twomey, Darragh, Elliott, Adrian D., Kalman, Jonathan M., Abhayaratna, Walter P., Lau, Dennis H., Sanders, Prashanthan·2015·Journal of the American College of Cardiology

DOI 10.1016/j.jacc.2015.03.002

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Abstract

Background Obesity and atrial fibrillation (AF) frequently coexist. Weight loss reduces the burden of AF, but whether this is sustained, has a dose effect, or is influenced by weight fluctuation is unknown.Objectives This study sought to evaluate the long-term impact of weight loss and weight fluctuation on rhythm control in obese individuals with AF.Methods Of 1,415 consecutive patients with AF, 825 had a body mass index ≥ 27 kg/m(2) and were offered weight management. After screening for exclusion criteria, 355 were included in this analysis. Weight loss was categorized as group 1 (≥ 10%), group 2 (3% to 9%), and group 3 (<3%). Weight trend and/or fluctuation was determined by yearly follow-up. We determined the impact on the AF severity scale and 7-day ambulatory monitoring.Results There were no differences in baseline characteristics or follow-up among the groups. AF burden and symptom severity decreased more in group 1 compared with groups 2 and 3 (p < 0.001 for all). Arrhythmia-free survival with and without rhythm control strategies was greatest in group 1 compared with groups 2 and 3 (p < 0.001 for both). In multivariate analyses, weight loss and weight fluctuation were independent predictors of outcomes (p < 0.001 for both). Weight loss ≥ 10% resulted in a 6-fold (95% confidence interval: 3.4 to 10.3; p < 0.001) greater probability of arrhythmia-free survival compared with the other 2 groups. Weight fluctuation >5% partially offset this benefit, with a 2-fold (95% confidence interval: 1.0 to 4.3; p = 0.02) increased risk of arrhythmia recurrence.Conclusions Long-term sustained weight loss is associated with significant reduction of AF burden and maintenance of sinus rhythm. (Long-Term Effect of Goal directed weight management on Atrial Fibrillation Cohort: A 5 Year follow-up study [LEGACY Study]; ACTRN12614001123639).

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Authors: Pathak, R. K., Middeldorp, M. E., Meredith, M., Mehta, A. B., Mahajan, R., Wong, C. X., Twomey, D., Elliott, A. D., Kalman, J. M., Abhayaratna, W. P., Lau, D. H., & Sanders, P.
Affiliations: Royal Adelaide Hospital (AU)
Australian National University (AU)
The Royal Melbourne Hospital (AU)
Corresponding author: Sanders, Prashanthan
ORCID: Pathak, Rajeev K.
Middeldorp, Melissa E.
Mehta, Abhinav B.
Mahajan, Rajiv
Wong, Christopher X.
Twomey, Darragh
Elliott, Adrian D.
Kalman, Jonathan M.
Abhayaratna, Walter P.
Lau, Dennis H.
Sanders, Prashanthan
Venue: Journal of the American College of Cardiology
Publisher: Elsevier BV
Published: 2015-05
Volume: 65
Issue: 20
Pages: 2159-2169
ISSN: 0735-1097 (ISSN-L)
DOI: 10.1016/j.jacc.2015.03.002
OpenAlex: W2102904190
Cited by: 1,036
References: 34
Citations by year: 2026: 97 · 2025: 100 · 2024: 91 · 2023: 95 · 2022: 73 · 2021: 108 · 2020: 97 · 2019: 96 · 2018: 73 · 2017: 85 · 2016: 81 · 2015: 39
FWCI: 66.78
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (vor, 391 d)
Locations: Journal of the American College of Cardiology (publishedVersion)
PubMed (publishedVersion)
Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
ANU Open Research (Australian National University) (submittedVersion)
Funders: Lions Medical Research Foundation
National Heart Foundation of Australia
University of Adelaide
Rhodes College
National Health and Medical Research Council
Centre for Heart Rhythm Disorders, University of Adelaide
Topics: Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
Keywords: atrial fibrillation, obesity, weight loss, weight variation, arrhythmia burden, rhythm control, arrhythmia-free survival, sinus rhythm maintenance, body mass index
MeSH terms: Aged, Atrial Fibrillation, Female, Follow-Up Studies, Goals, Humans, Male, Middle Aged, Obesity, Severity of Illness Index, Time, Time Factors, Weight Loss

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Long-Term Effect of Goal-Directed Weight Management in an Atrial Fibrillation Cohort

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