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Weight Loss, Risk Management May Reverse Atrial Fibrillation Progression

Weight loss and aggressive risk factor management can alter atrial fibrillation (AF) disease progression in overweight or obese patients, results of a new study suggest.

The Prevention and Regressive Effect of Weight Loss and Risk Factor Modification on Atrial Fibrillation (REVERSE-AF) study examined the impact of obesity and weight loss on AF progression in 355 AF patients with a body-mass index (BMI)>27 kg/m2. It found that only 3% of patients with sustained weight loss >10% progressed from paroxysmal to persistent AF compared with 32% who lost 3% to 9% and 48% who lost <3% (P<0.001).

At the same time, 36% of patients with >10% weight loss had AF reversed from persistent to paroxysmal vs 17% in group 2 and 1% in group 3 (P<.001). The data were reported at the Heart Rhythm Society (HRS) 2016 Scientific Sessions.

REVERSE-AF is the third study in a little over a year to support the benefits of weight loss and risk reduction in the management of AF. Last March, the Australian team also demonstrated a significant dose-response effect of weight reduction on AF symptom burden in the LEGACY trial. The data was quickly followed by the CARDIO-FIT trial showing that increased cardiorespiratory fitness is linked to a dose-dependent reduction in AF symptoms and also predicts recurrence in obese patients.