TY - JOUR
T1 - The effect of weight loss on recurrence of atrial fibrillation after catheter ablation: a systematic review and meta-analysis
AU - Akhtar, Khawaja Hassan
AU - Jafry, Ali Haider
AU - Beard, Christopher
AU - Nasir, Yusra Minahil
AU - Agarwal, Siddharth
AU - Khan, Jehanzeb
AU - Clifton, Shari
AU - Reece, Jessica
AU - Munir, Muhammad Bilal
AU - Deshmukh, Abhishek
AU - DeSimone, Christopher V.
AU - Jackman, Warren M.
AU - Stavrakis, Stavros
AU - Po, Sunny
AU - Sanders, Prashanthan
AU - Asad, Zain Ul Abideen
N1 - Funding Information:
This work was supported by an Education Research Grant from Academy of Teaching Scholars University of Oklahoma College of Medicine awarded to Zain Ul Abideen Asad, MD MS.
Publisher Copyright:
© 2023 Wiley Periodicals LLC.
PY - 2023/10/3
Y1 - 2023/10/3
N2 - 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.
AB - 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.
KW - atrial fibrillation
KW - catheter ablation
KW - meta-analysis
KW - systematic review
KW - weight loss
UR - http://www.scopus.com/inward/record.url?scp=85173449232&partnerID=8YFLogxK
U2 - 10.1111/jce.16090
DO - 10.1111/jce.16090
M3 - Article
AN - SCOPUS:85173449232
SN - 1045-3873
VL - 34
SP - 2514
EP - 2526
JO - Journal of Cardiovascular Electrophysiology
JF - Journal of Cardiovascular Electrophysiology
IS - 12
ER -