Background
Obesity and obstructive sleep apnea (
OSA
) are associated with atrial fibrillation (
AF
), yet these conditions remain inadequately treated. We report on the feasibility and efficacy of a nurse‐led risk factor modification program utilizing a pragmatic approach to address obesity and
OSA
in
AF
patients.
Methods and Results
AF
patients with obesity (body mass index ≥30 kg/m
2
) and/or the need for
OSA
management (high risk per Berlin Questionnaire or untreated
OSA
) were voluntarily enrolled for risk factor modification, which comprised patient education, lifestyle modification, coordination with specialists, and longitudinal management. Weight loss and
OSA
treatment were monitored by monthly follow‐up calls and/or continuous positive airway pressure (
CPAP
) unit downloads. Quality of life and arrhythmia symptoms were assessed with the
SF
‐36 and
AF
Severity Scale at baseline and at 6 months. From November 1, 2016 to October 31, 2017, 252 patients (age 63±11 years; 71% male; 57% paroxysmal
AF
) were enrolled, 189 for obesity and 93 for
OSA
. Obese patients who enrolled lost significantly greater percent body weight than those who declined (3% versus 0.3%;
P
<0.05). Among 93 patients enrolled for
OSA
, 70 completed sleep studies,
OSA
was confirmed in 50, and the majority (76%) started
CPAP
therapy. All components of quality of life and arrhythmia symptoms improved significantly from baseline to 6 months among enrolled patients.
Conclusions
A nurse‐led risk factor modification program is a potentially sustainable and generalizable model that can improve weight loss and
OSA
in
AF
patients, translating into improved quality of life and arrhythmia symptoms.