Gessler, Nele, Willems, Stephan, Steven, Daniel, Aberle, Jens, Akbulak, Ruken Oezge, Gosau, Nils ORCID: 0000-0002-7888-9204, Hoffmann, Boris A., Meyer, Christian, Sultan, Arian, Tilz, Roland, Vogler, Julia, Wohlmuth, Peter, Scholz, Susanne, Gunawardene, Melanie A., Eickholt, Christian and Lueker, Jakob (2021). Supervised Obesity Reduction Trial for AF ablation patients: from the SORT-AF trial. Europace, 23 (10). S. 1548 - 1559. OXFORD: OXFORD UNIV PRESS. ISSN 1532-2092

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Abstract

Aims Weight management seems to be beneficial for obese atrial fibrillation (AF) patients; however, randomized data are sparse. Thus, this study aimed to investigate the influence of weight reduction on AF ablation outcomes. Methods and results SORT-AF is an investigator-sponsored, prospective, randomized, multicentre, and clinical trial. Patients with symptomatic AF (paroxysmal or persistent) and body mass index (BMI) 30-40 kg/m(2) underwent AF ablation and were randomized to either weight-reduction (group 1) or usual care (group 2), after sleep-apnoea-screening and loop recorder (ILR) implantation. The primary endpoint was defined as AF burden between 3 and 12 months after AF ablation. Overall, 133 patients (60 +/- 10 years, 57% persistent AF) were randomized to group 1 (n = 67) and group 2 (n =66), respectively. Complications after AF-ablation were rare (one stroke and no tamponade). The intervention led to a significant reduction of BMI (34.9 +/- 2.6-33.4 +/- 3.6) in group 1 compared to a stable BMI in group 2 (P <0.001). Atrial fibrillation burden after ablation decreased significantly (P < 0 .001), with no significant difference regarding the primary endpoint between the groups (P = 0 .815, odds ratio: 1.143, confidence interval: 0.369-3.613). Further analyses showed a significant correlation between BMI and AF recurrence for patients with persistent AF compared with paroxysmal AF patients (P = 0.032). Conclusion The SORT-AF study shows that AF ablation is safe and successful in obese patients using continuous monitoring via ILR. Although the primary endpoint of AF burden after ablation did not differ between the two groups, the effects of weight toss and improvement of exercise activity were beneficial for obese patients with persistent AF demonstrating the relevance of life-style management as an important adjunct to AF ablation in this setting.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Gessler, NeleUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Willems, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Steven, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Aberle, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Akbulak, Ruken OezgeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gosau, NilsUNSPECIFIEDorcid.org/0000-0002-7888-9204UNSPECIFIED
Hoffmann, Boris A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meyer, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sultan, ArianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Tilz, RolandUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Vogler, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wohlmuth, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Scholz, SusanneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gunawardene, Melanie A.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eickholt, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Lueker, JakobUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-600239
DOI: 10.1093/europace/euab122
Journal or Publication Title: Europace
Volume: 23
Number: 10
Page Range: S. 1548 - 1559
Date: 2021
Publisher: OXFORD UNIV PRESS
Place of Publication: OXFORD
ISSN: 1532-2092
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
ATRIAL-FIBRILLATION; MANAGEMENT; WEIGHT; RISK; CRYOBALLOON; EXERCISEMultiple languages
Cardiac & Cardiovascular SystemsMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60023

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