Lose Weight to Treat Abnormal Heart Rhythm In A Right Way

The new study suggests that overweight patients undergoing treatment for abnormal heart rhythm should lose weight before the procedure.

Overweight patients with atrial fibrillation are more likely to experience a return of the heart rhythm disorder after a corrective procedure than those of normal weight, according to research presented at EHRA 2022, a scientific congress of the European Society of Cardiology.

“The risk of recurrent atrial fibrillation after ablation rose incrementally as body mass index (BMI) increased,” said lead author Dr. Jacob Toennesen of Gentofte University Hospital, Denmark.

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‘61% of normal-weight patients were free of abnormal heart rhythm after one year compared to 52% of obese patients who underwent treatment for atrial fibrillation.’

Atrial fibrillation is the most common heart rhythm disorder worldwide. It is estimated that one in three Europeans will develop the condition. Atrial fibrillation is associated with elevated risks of stroke, heart failure, and premature death, while more than 60% of patients have impaired quality of life.

Treatment options include drugs and ablation, which involves burning or freezing a small portion of the heart to create a scar and prevent the spread of abnormal electrical impulses.

While previous research has shown that obesity is associated with the development of atrial fibrillation, this new study examined the link between BMI and a return of heart rhythm disorder after ablation.

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The study was conducted using Danish nationwide registries. It included a total of 9,229 adults who underwent first-time atrial fibrillation from 2010 through 2018.

Patients were divided into five groups according to BMI in kg/m2: underweight (below 18.5), normal weight (18.5 to 24), overweight (25 to 29), obese (30 to 34), and morbidly obese (over 34). The median age decreased from 64 years in the normal weight group to 60 years in the morbidly obese group.

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Patients were deemed to have experienced atrial fibrillation during follow-up if they claimed prescriptions of anti-arrhythmic drugs, were hospitalized due to atrial fibrillation, underwent re-ablation, or had electrical cardioversion which transmits electric shocks to the heart through electrodes on the chest to restore normal heart rhythm.

The authors analyzed the relative risk of recurrent atrial fibrillation according to BMI after adjusting for sex, age, procedure year, heart failure, ischaemic heart disease, chronic obstructive pulmonary disease (COPD), chronic kidney disease, hypertension, and diabetes.

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At one year, compared to the normal-weight group, the overweight, obese, and morbidly obese groups had a 19%, 22%, and 32% higher likelihood of atrial fibrillation, respectively.

The same pattern was observed after five years, with 15%, 18%, and 26% higher risks of abnormal heart rhythm in the overweight, obese, and morbidly obese groups, respectively, compared with the normal weight group.

The strength of association between high BMI and repeat atrial fibrillation after ablation was comparable to the influence of well-known factors like heart failure, COPD, and hypertension which are typically treated in these patients. The findings indicate that aggressive weight management before ablation could potentially lead to better outcomes.

Source-Medindia