Impact of weight loss on ablation outcome in obese patients with longstanding persistent atrial fibrillation

Sanghamitra Mohanty, Prasant Mohanty, Veronica Natale, Chintan Trivedi, Carola Gianni, J. David Burkhardt, Javier E. Sanchez, Rodney Horton, G. Joseph Gallinghouse, Richard Hongo, Salwa Beheiry, Amin Al-Ahmad, Luigi Di Biase, Andrea Natale

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Aims: This study investigated the impact of weight loss in longstanding persistent (LSPAF) patients undergoing catheter ablation (CA). Methods: Ninety consecutive obese LSPAF patients were approached; 58 volunteered to try weight loss interventions for up to 1 year (group 1), while 32 patients declined weight loss interventions and were included as a control (group 2). Both groups remained on antiarrhythmic drugs. If they continued to experience AF, CA was performed. Body weight was measured at 6-month intervals and arrhythmia status was assessed by event recorder, electrocardiogram (ECG), and Holter monitoring. Symptom severity and quality of life (QoL) were evaluated by AFSS and SF-36 survey, respectively. A scoring algorithm with two summary measures, physical component score (PCS) and mental component score (MCS), was prepared for QoL analysis. Results: Significant reduction in body weight (median -24.9 (IQR -19.1 to -56.7) kg, P < 0.001) was observed in the group 1 patients, while no such change was seen in group 2. The PCS and MCS scores improved significantly in group 1 only, with a change from baseline of 8.4 ± 3 (P = 0.013) and 12.8 ± 8.2 (P < 0.02). However, AF symptom severity remained unchanged from baseline in both groups (P = 0.84). All 90 patients eventually underwent CA and received PVAI+ posterior wall+ non-PV triggers ablation. At 1-year follow-up after single procedure, 37 (63.8%) in group 1 and 19 (59.3%) patients in group 2 remained arrhythmia-free off AAD (P = 0.68). Conclusion: In this prospective analysis, in LSPAF patients weight loss improved QoL but had no impact on symptom severity and long-term ablation outcome.

Original languageEnglish (US)
JournalJournal of Cardiovascular Electrophysiology
DOIs
StateAccepted/In press - Jan 1 2017

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Atrial Fibrillation
Weight Loss
Catheter Ablation
Quality of Life
Cardiac Arrhythmias
Body Weight
Ambulatory Electrocardiography
Anti-Arrhythmia Agents
Electrocardiography
Control Groups

Keywords

  • AF recurrence
  • Catheter ablation
  • Longstanding persistent AF
  • Quality of life
  • Symptom severity
  • Weight loss

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Impact of weight loss on ablation outcome in obese patients with longstanding persistent atrial fibrillation. / Mohanty, Sanghamitra; Mohanty, Prasant; Natale, Veronica; Trivedi, Chintan; Gianni, Carola; Burkhardt, J. David; Sanchez, Javier E.; Horton, Rodney; Gallinghouse, G. Joseph; Hongo, Richard; Beheiry, Salwa; Al-Ahmad, Amin; Di Biase, Luigi; Natale, Andrea.

In: Journal of Cardiovascular Electrophysiology, 01.01.2017.

Research output: Contribution to journalArticle

Mohanty, S, Mohanty, P, Natale, V, Trivedi, C, Gianni, C, Burkhardt, JD, Sanchez, JE, Horton, R, Gallinghouse, GJ, Hongo, R, Beheiry, S, Al-Ahmad, A, Di Biase, L & Natale, A 2017, 'Impact of weight loss on ablation outcome in obese patients with longstanding persistent atrial fibrillation', Journal of Cardiovascular Electrophysiology. https://doi.org/10.1111/jce.13394
Mohanty, Sanghamitra ; Mohanty, Prasant ; Natale, Veronica ; Trivedi, Chintan ; Gianni, Carola ; Burkhardt, J. David ; Sanchez, Javier E. ; Horton, Rodney ; Gallinghouse, G. Joseph ; Hongo, Richard ; Beheiry, Salwa ; Al-Ahmad, Amin ; Di Biase, Luigi ; Natale, Andrea. / Impact of weight loss on ablation outcome in obese patients with longstanding persistent atrial fibrillation. In: Journal of Cardiovascular Electrophysiology. 2017.
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abstract = "Aims: This study investigated the impact of weight loss in longstanding persistent (LSPAF) patients undergoing catheter ablation (CA). Methods: Ninety consecutive obese LSPAF patients were approached; 58 volunteered to try weight loss interventions for up to 1 year (group 1), while 32 patients declined weight loss interventions and were included as a control (group 2). Both groups remained on antiarrhythmic drugs. If they continued to experience AF, CA was performed. Body weight was measured at 6-month intervals and arrhythmia status was assessed by event recorder, electrocardiogram (ECG), and Holter monitoring. Symptom severity and quality of life (QoL) were evaluated by AFSS and SF-36 survey, respectively. A scoring algorithm with two summary measures, physical component score (PCS) and mental component score (MCS), was prepared for QoL analysis. Results: Significant reduction in body weight (median -24.9 (IQR -19.1 to -56.7) kg, P < 0.001) was observed in the group 1 patients, while no such change was seen in group 2. The PCS and MCS scores improved significantly in group 1 only, with a change from baseline of 8.4 ± 3 (P = 0.013) and 12.8 ± 8.2 (P < 0.02). However, AF symptom severity remained unchanged from baseline in both groups (P = 0.84). All 90 patients eventually underwent CA and received PVAI+ posterior wall+ non-PV triggers ablation. At 1-year follow-up after single procedure, 37 (63.8{\%}) in group 1 and 19 (59.3{\%}) patients in group 2 remained arrhythmia-free off AAD (P = 0.68). Conclusion: In this prospective analysis, in LSPAF patients weight loss improved QoL but had no impact on symptom severity and long-term ablation outcome.",
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AU - Mohanty, Sanghamitra

AU - Mohanty, Prasant

AU - Natale, Veronica

AU - Trivedi, Chintan

AU - Gianni, Carola

AU - Burkhardt, J. David

AU - Sanchez, Javier E.

AU - Horton, Rodney

AU - Gallinghouse, G. Joseph

AU - Hongo, Richard

AU - Beheiry, Salwa

AU - Al-Ahmad, Amin

AU - Di Biase, Luigi

AU - Natale, Andrea

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N2 - Aims: This study investigated the impact of weight loss in longstanding persistent (LSPAF) patients undergoing catheter ablation (CA). Methods: Ninety consecutive obese LSPAF patients were approached; 58 volunteered to try weight loss interventions for up to 1 year (group 1), while 32 patients declined weight loss interventions and were included as a control (group 2). Both groups remained on antiarrhythmic drugs. If they continued to experience AF, CA was performed. Body weight was measured at 6-month intervals and arrhythmia status was assessed by event recorder, electrocardiogram (ECG), and Holter monitoring. Symptom severity and quality of life (QoL) were evaluated by AFSS and SF-36 survey, respectively. A scoring algorithm with two summary measures, physical component score (PCS) and mental component score (MCS), was prepared for QoL analysis. Results: Significant reduction in body weight (median -24.9 (IQR -19.1 to -56.7) kg, P < 0.001) was observed in the group 1 patients, while no such change was seen in group 2. The PCS and MCS scores improved significantly in group 1 only, with a change from baseline of 8.4 ± 3 (P = 0.013) and 12.8 ± 8.2 (P < 0.02). However, AF symptom severity remained unchanged from baseline in both groups (P = 0.84). All 90 patients eventually underwent CA and received PVAI+ posterior wall+ non-PV triggers ablation. At 1-year follow-up after single procedure, 37 (63.8%) in group 1 and 19 (59.3%) patients in group 2 remained arrhythmia-free off AAD (P = 0.68). Conclusion: In this prospective analysis, in LSPAF patients weight loss improved QoL but had no impact on symptom severity and long-term ablation outcome.

AB - Aims: This study investigated the impact of weight loss in longstanding persistent (LSPAF) patients undergoing catheter ablation (CA). Methods: Ninety consecutive obese LSPAF patients were approached; 58 volunteered to try weight loss interventions for up to 1 year (group 1), while 32 patients declined weight loss interventions and were included as a control (group 2). Both groups remained on antiarrhythmic drugs. If they continued to experience AF, CA was performed. Body weight was measured at 6-month intervals and arrhythmia status was assessed by event recorder, electrocardiogram (ECG), and Holter monitoring. Symptom severity and quality of life (QoL) were evaluated by AFSS and SF-36 survey, respectively. A scoring algorithm with two summary measures, physical component score (PCS) and mental component score (MCS), was prepared for QoL analysis. Results: Significant reduction in body weight (median -24.9 (IQR -19.1 to -56.7) kg, P < 0.001) was observed in the group 1 patients, while no such change was seen in group 2. The PCS and MCS scores improved significantly in group 1 only, with a change from baseline of 8.4 ± 3 (P = 0.013) and 12.8 ± 8.2 (P < 0.02). However, AF symptom severity remained unchanged from baseline in both groups (P = 0.84). All 90 patients eventually underwent CA and received PVAI+ posterior wall+ non-PV triggers ablation. At 1-year follow-up after single procedure, 37 (63.8%) in group 1 and 19 (59.3%) patients in group 2 remained arrhythmia-free off AAD (P = 0.68). Conclusion: In this prospective analysis, in LSPAF patients weight loss improved QoL but had no impact on symptom severity and long-term ablation outcome.

KW - AF recurrence

KW - Catheter ablation

KW - Longstanding persistent AF

KW - Quality of life

KW - Symptom severity

KW - Weight loss

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