Lifestyle interventions after ablation for atrial fibrillation: a systematic review

Abstract

Background Risk factors of atrial fibrillation include diabetes, obesity and physical inactivity. Positive effects such as decreased atrial fibrillation burden have been reported for atrial fibrillation patients who have participated in lifestyle changing interventions after atrial fibrillation ablation treatment. Aim The aim of this study was to assess the evidence on the benefits and harms of lifestyle and risk factor management interventions in patients undergoing atrial fibrillation ablation. Method Our systematic review searched MEDLINE, EMBASE, CINAHL, Psychinfo, Web of Science and CENTRAL using key terms related to atrial fibrillation and lifestyle, including interventional trials. The primary outcomes were mortality and serious adverse events. Random effects meta-analyses of outcomes were conducted when appropriate. Results Two randomised controlled trials and two non-randomised interventional trials with a total of 498 patients were included. Six primary events were reported for the intervention groups and five events for the control groups (relative risk of 1.03, 95% confidence interval (CI) 0.3 to 3.1, I2 0%, P = 0.537). Effects in favour of the intervention groups were found for atrial fibrillation frequency (0.82 points, 95% CI –1.60 to –0.03, I2 87.3%, P = 0.005), atrial fibrillation duration (–0.76 points, 95% CI –1.64 to 0.12, I2 89.1%, P = 0.002) and body mass index (–5.40 kg/m2, 95% CI 6.22 to –2.57, I2 83.9%, P = 0.013). Risk of bias in the four studies was judged to be low to moderate. Conclusion Lifestyle changing interventions seem to have a positive effect on outcomes relevant to patients undergoing atrial fibrillation ablation, but the included studies were small, interventions were inhomogeneous, and the quality of evidence was low to moderate. More studies are warranted.

The counterintuitive role of exercise in the prevention and cause of atrial fibrillation

“…A recent systematic review of four interventional studies (n=498 participants) found lifestyle and risk factor management significantly decreased AF episode severity, frequency, and duration (36). Supporting the notion of exercise as an AF-specific medical intervention, one previous study demonstrated improved sinus rhythm maintenance in patients with persistent AF, following external electrical cardioversion and rhythm control therapy (usual care) plus exercise, counselling, and dietary restriction compared to usual care alone (37).…”

Association Between Risk Factors and Readmission for Patients With Atrial Fibrillation Treated With Catheter Ablation

“…A recently published review identified only 4 risk-factor intervention studies for patients treated with ablation for AF 32 . Tested interventions varied in elements, time, and setting and included physical exercise and psychoeducational consultations, nurse-led educational sessions, and dietician counseling sessions with personalized diet plans and moderate-intensity exercise training.…”

La enfermera experta en fibrilación auricular

“…Otra rama importante de las funciones de la enfermera experta en FA es el manejo de los factores de riesgo modificables que pueden provocar o intensificar los episodios de FA 31 . Es importante identificar aquellos pacientes con obesidad o AOS para poder establecer un tratamiento adecuado para su control 32 .…”