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The effect of weight loss on recurrence of atrial fibrillation after catheter ablation: A systematic review and meta-analysis.
Akhtar, Khawaja Hassan; Jafry, Ali Haider; Beard, Christopher; Nasir, Yusra Minahil; Agarwal, Siddharth; Khan, Jehanzeb; Clifton, Shari; Reece, Jessica; Munir, Muhammad Bilal; Deshmukh, Abhishek; DeSimone, Christopher V; Jackman, Warren M; Stavrakis, Stavros; Po, Sunny; Sanders, Prashanthan; Asad, Zain Ul Abideen.
Affiliation
  • Akhtar KH; Department of Medicine, Section of Cardiovascular Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
  • Jafry AH; Department of Medicine, Section of Cardiovascular Medicine, Allegheny General Hospital, Pittsburgh, Pennsylvania, USA.
  • Beard C; Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
  • Nasir YM; Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
  • Agarwal S; Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
  • Khan J; Department of Medicine, Section of Cardiovascular Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
  • Clifton S; Robert M. Bird Health Sciences Library, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
  • Reece J; Department of Biostatistics and Epidemiology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
  • Munir MB; Division of Cardiovascular Medicine, University of California Davis, Sacramento, California, USA.
  • Deshmukh A; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • DeSimone CV; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
  • Jackman WM; Department of Medicine, Section of Cardiovascular Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
  • Stavrakis S; Department of Medicine, Section of Cardiovascular Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
  • Po S; Department of Medicine, Section of Cardiovascular Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
  • Sanders P; University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia.
  • Asad ZUA; Department of Medicine, Section of Cardiovascular Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
J Cardiovasc Electrophysiol ; 34(12): 2514-2526, 2023 Dec.
Article in En | MEDLINE | ID: mdl-37787013
BACKGROUND: Obesity is associated with an increased risk of developing recurrent atrial fibrillation (AF) after catheter ablation (CA). However, the current data on weight loss interventions show inconsistent results in preventing the recurrence of AF after CA. METHODS: We conducted a systematic search in MEDLINE and EMBASE to identify studies that reported the outcome of recurrence of AF after CA in obese patients undergoing weight interventions. The subgroup analysis included: (1) Weight loss versus no weight loss, (2) >10% weight loss versus <10% weight loss, (3) <10% weight loss versus no weight loss, (4) Follow-up <12 months, and (5) Follow-up >12 months after CA. Mantel-Haenszel risk ratios with a 95% confidence interval (CI) were calculated using a random effects model and for heterogeneity, I2 statistics were reported. RESULTS: A total of 10 studies (one randomized controlled trial and nine observational studies) comprising 1851 patients were included. The recurrence of AF was numerically reduced in the weight loss group (34.5%) versus no weight loss group (58.2%), but no statistically significant difference was observed (risk ratio [RR] = 0.76; 95% CI: 0.49-1.18, p = .22). However, there was a statistically significant reduction in recurrence of AF with weight loss versus no weight loss at follow-up >12 months after CA (RR = 0.47; 95% CI: 0.32-0.68, p < .0001). At follow-up >12 months after CA, both >10% weight loss versus <10% weight loss (RR = 0.49; 95% CI: 0.31-0.80, p = .004) and <10% weight loss versus no weight loss (RR = 0.39; 95% CI: 0.31-0.49, p < .00001) were associated with a statistically significant reduction in recurrent AF. CONCLUSION: In patients with AF undergoing CA, weight loss is associated with reducing recurrent AF at > 12 months after ablation and these benefits are consistently seen with both >10% and <10% weight loss. The benefits of weight loss in preventing recurrent AF after CA should be examined in larger studies with extended follow-up duration.
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Atrial Fibrillation / Catheter Ablation Type of study: Clinical_trials / Observational_studies / Systematic_reviews Limits: Humans Language: En Journal: J Cardiovasc Electrophysiol Journal subject: ANGIOLOGIA / CARDIOLOGIA / FISIOLOGIA Year: 2023 Document type: Article Affiliation country: United States Country of publication: United States
Fulltext
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Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Atrial Fibrillation / Catheter Ablation Type of study: Clinical_trials / Observational_studies / Systematic_reviews Limits: Humans Language: En Journal: J Cardiovasc Electrophysiol Journal subject: ANGIOLOGIA / CARDIOLOGIA / FISIOLOGIA Year: 2023 Document type: Article Affiliation country: United States Country of publication: United States