- Question
- Does structured lifestyle and risk factor management improve rhythm outcomes after catheter ablation of atrial fibrillation (AF) in patients with overweight or obesity?
- Design
- Open-label, multicenter, randomized clinical trial of 122 participants at 3 sites in Adelaide, South Australia, with 12-month follow-up. Randomization was 1:1 and the team managing AF was blinded to allocation.
- Population
- Consecutive patients with nonpermanent symptomatic AF undergoing first-time catheter ablation, with a body mass index of 27 or higher and at least one additional cardiometabolic risk factor.
- Intervention
- Lifestyle and risk factor management (LRFM) in a structured, physician-led, tailored clinic aimed at reducing modifiable risk factors.
- Control
- Usual care: the treating physician provided information on risk factor management, but patients were not enrolled in the risk factor modification clinic.
- Primary outcome
- Proportion of patients free from AF during the 12 months after ablation.
- Results
- The primary endpoint was met by 38 patients (61.3%) in the LRFM group and 24 (40%) in the control group (P = .03); the hazard ratio for recurrent arrhythmia over 12 months was 0.53 (95% CI, 0.32-0.89). AF symptom severity improved more in the LRFM group (mean difference, -2.0; 95% CI, -3.7 to -0.3).
- Conclusion
- In patients with AF, elevated BMI, and additional cardiometabolic risk factors, aggressive risk factor management reduced arrhythmia recurrence in the 12 months after catheter ablation.
- Why it matters
- It provides randomized evidence that structured management of weight and risk factors complements ablation and helps maintain sinus rhythm, supporting what previously came only from observational studies.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 14, 2026