The effect of weight loss on recurrence of atrial fibrillation after catheter ablation: A systematic review and meta‐analysis-Reference-Cited by-同舟云学术

The effect of weight loss on recurrence of atrial fibrillation after catheter ablation: A systematic review and meta‐analysis

Published:2023-10-03 Issue:12 Volume:34 Page:2514-2526
ISSN:1045-3873
Container-title:Journal of Cardiovascular Electrophysiology
language:en
Short-container-title:Cardiovasc electrophysiol

Author:

Akhtar Khawaja Hassan¹,Jafry Ali Haider²^ORCID,Beard Christopher³,Nasir Yusra Minahil³,Agarwal Siddharth³,Khan Jehanzeb¹,Clifton Shari⁴,Reece Jessica⁵,Munir Muhammad Bilal⁶,Deshmukh Abhishek⁷^ORCID,DeSimone Christopher V.⁷^ORCID,Jackman Warren M.¹,Stavrakis Stavros¹^ORCID,Po Sunny¹,Sanders Prashanthan⁸^ORCID,Asad Zain Ul Abideen¹^ORCID

Affiliation:

1. Department of Medicine, Section of Cardiovascular Medicine University of Oklahoma Health Sciences Center Oklahoma City Oklahoma USA

2. Department of Medicine, Section of Cardiovascular Medicine Allegheny General Hospital Pittsburgh Pennsylvania USA

3. Department of Medicine University of Oklahoma Health Sciences Center Oklahoma City Oklahoma USA

4. Robert M. Bird Health Sciences Library University of Oklahoma Health Sciences Center Oklahoma City Oklahoma USA

5. Department of Biostatistics and Epidemiology University of Oklahoma Health Sciences Center Oklahoma City Oklahoma USA

6. Division of Cardiovascular Medicine University of California Davis Sacramento California USA

7. Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USA

8. University of Adelaide and Royal Adelaide Hospital Adelaide Australia

Abstract

AbstractBackgroundObesity 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.MethodsWe 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.ResultsA 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.ConclusionIn 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.

Publisher

Wiley

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

Link

https://onlinelibrary.wiley.com/doi/pdf/10.1111/jce.16090

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