MedicalResearch.com Interview with:
Sanghamitra Mohanty, MD MS FHRS
Director, translational research, Texas Cardiac Arrhythmia Institute and Associate Professor (affiliate) Dell Medical School
What is the background for this study? What are the main findings?
Dr. Mohanty: In the last few years, several trials from a research group in Australia have generated tremendous interest in life-style modifications to manage AF more effectively. These studies reported significant decrease in arrhythmia burden and symptom severity and improvement in ablation outcome in patients with paroxysmal and persistent atrial fibrillation. We investigated the impact of weight-loss on procedure outcome in terms of arrhythmia burden, quality of life and arrhythmia-free survival in long-standing persistent (LSPAF) patients undergoing catheter ablation.
Our main findings were the following;
- In patients with long-standing persistent atrial fibrillation, weight loss improved quality of life but had no impact on symptom burden and long-term ablation outcome
- No change in AF type or status was detected after the weight loss
- Extensive ablation including pulmonary vein (PV) isolation plus ablation of posterior wall and non-PV triggers resulted in comparable outcome in both groups at 1-year follow-up, irrespective of weight-loss interventions (63.8% vs 59.3%, p=0.68).
MedicalResearch.com: What should readers take away from your report?
Dr. Mohanty: In LSPAF patients, weight-loss improves quality of life but does not reverse the arrhythmia or reduce the disease burden. Patients need ablation of the PV- and non-PV triggers for long-term restoration of sinus rhythm.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Dr. Mohanty: Multi-center randomized controlled trials on larger populations with standardized weight-loss plans (diet and exercise measures) and implantable loop recorders for continuous arrhythmia-monitoring would be helpful in confirming the findings reported so far while minimizing any selection bias and impact of confounders.
MedicalResearch.com: Is there anything else you would like to add?
Dr. Mohanty: Our results do not attempt to minimize the benefits of weight loss in this subset of AF population. Rather, we emphasize the need for weight reduction in these patients not only because it enhances quality of life but also it is well known to improve other cardiovascular risk factors such as diabetes and hypertension which are known risk factors for AF.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Impact Of Weight Loss On Ablation-Outcome In Obese Patients With Long-Standing Persistent Atrial Fibrillation
Sanghamitra Mohanty, MD, FHRS, Prasant Mohanty, MD, MPH, Chintan Trivedi, MD, MPH, Carola Gianni, MD, Yalcin Gokoglan, MD, Rong Bai, MD, J. David Burkhardt, MD, Javier E. Sanchez, MD, Patrick Hranitzky, MD, FHRS, G. Joseph Gallinghouse, MD, Amin Al-Ahmad, MD, FHRS, Rodney P. Horton, MD, Richard H. Hongo, MD, Salwa Beheiry, RN, Luigi Di Biase, MD, PHD, FHRS and Andrea Natale, MD, FHRS. St. David’s Medical Center, Austin, TX, Texas Cardiac Arrhythmia Institute at St. David’s Medical Center, Austin, TX, Dipartimento di Scienze Cliniche e di Comunità, Milano, Italy, Texas Cardiac Arrhythmia Institute, Austin, TX, Texas Cardiac Arrhythmia Research, Austin, TX, Northern California Heart Care, San Francisco, CA, California Pacific Medical Center, San Francisco, CA, Texas Cardiac Arrhythmia Institute at St. David’s Medical Center and Albert Einstein College of Medicine at Montefiore Hospital, Austin, TX
Mohanty:None. P. Mohanty: None. C. Trivedi: None. C. Gianni: None. Y. Gokoglan: None. R. Bai: None. J. Burkhardt: None. J.E. Sanchez:None. P. Hranitzky: None. G. Gallinghouse: None. A. Al-Ahmad: None. R.P. Horton: None. R.H. Hongo: None. S. Beheiry: None. L. Di Biase: A – Compensation for Services; 1; Biosense Webster, Inc., St. Jude Medical, Stereotaxis, Inc.. B – Speaker’s Bureau; 1; Biotronik, Medtronic, Inc., EpiEP, Boston Scientific Corp., Janssen Pharmaceuticals, Pfizer, Inc. A. Natale: A – Compensation for Services; 1; St. Jude Medical, Janssen Pharmaceuticals, Biosense Webster, Inc.. B – Speaker’s Bureau; 1; Boston Scientific Corp., Biotronik, Medtronic, Inc., Biosense Webster, Inc., St. Jude Medical.
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