Key Points<\/p>\n
Prior observational studies have pointed to the role of aggressive risk factor modification (RFM) in improving long-term outcomes after catheter ablation for atrial fibrillation (AF). However, randomized controlled trial data to validate this hypothesis has been lacking.<\/p>\n
On November 18th<\/sup> \u00a02024, the results of \u201cAggressive Risk factor REduction STudy for Atrial Fibrillation (ARREST-AF) implications for ablation outcomes: A Randomized Clinical Trial\u201d were presented at AHA Scientific Sessions 2024.<\/em> The purpose of this study was to determine if attempts at intensive RFM after AF ablation improves outcomes.<\/p>\n This randomized controlled trial included 122 consecutive Australian adult patients with paroxysmal or persistent symptomatic AF undergoing catheter ablation (pulmonary vein isolation with additional ablation at operator discretion) who had a body mass index of \u2265 27 kg\/m2 <\/sup>and one additional cardiometabolic risk factor.\u00a0 Patients with severe structural heart or systemic disease were excluded.\u00a0 They were assigned in a 1:1 fashion at to RFM or usual care arm. Patients in the RFM arm received intensive risk factor management through a physician-led clinic, following AHA guideline-based recommendations. Patients in the usual care arm received standard, guideline-directed care for AF management. The primary endpoint was proportion of patients free from AF recurrence 12 months post-ablation. Secondary endpoints included changes in AF symptom severity, cardiometabolic risk factors, exercise capacity and need for redo ablation.<\/p>\n At 12 months, 66% of patients in the RFM group were free from AF recurrence at 12 months, compared to 42% in the usual care group, a significant difference (HR 2.18 [95% CI 1.25-3.70]; p=0.004).\u00a0 In addition, AF symptom severity was significantly improved in the RFM group compared to the usual care group. The RFM group also had significantly improved body weight, glycemic control, and exercise capacity, indicating that the intervention was successful at achieving an improvement in control of major cardiometabolic risk factors.<\/p>\n Rajeev K. Pathak, MD, PhD, FACC, Director of Cardiac Electrophysiology at Canberra Heart Rhythm \u00a0in Garran, Australia, concluded: \u201cAmongst patients with AF, elevated BMI and one additional cardiometabolic risk factor, aggressive risk factor management reduces arrhythmia recurrence in the 12-months following catheter ablation when compared with usual care.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":" Key Points Observation data has suggested that improving cardiometabolic risk factors after AF ablation may reduce the recurrence of arrythmias. The ARREST-AF trial provides randomized controlled evidence demonstrating the benefits of a physician-led clinic focusing on risk factor modification (RFM) in reducing arrhythmia recurrence at 12 months. Patients in the RFM group were significantly more […]<\/p>\n","protected":false},"author":40618,"featured_media":138603,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[896,8],"tags":[897,45,47,185],"ppma_author":[1072],"class_list":{"0":"post-138602","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-aha-2024","8":"category-news","9":"tag-aha-2024","10":"tag-conference","11":"tag-featured","12":"tag-news","13":"author-lucas-marinacci-md"},"authors":[{"term_id":1072,"user_id":40618,"is_guest":0,"slug":"lucas-marinacci-md","display_name":"Lucas Marinacci MD","avatar_url":"https:\/\/secure.gravatar.com\/avatar\/cd81d2064c6f6263719c24aeb738faf718e9bd869c5a840718bc535238ae72f6?s=96&r=g","0":null,"1":"","2":"","3":"","4":"","5":"","6":"","7":"","8":""}],"_links":{"self":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138602","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/users\/40618"}],"replies":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=138602"}],"version-history":[{"count":2,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138602\/revisions"}],"predecessor-version":[{"id":138605,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/posts\/138602\/revisions\/138605"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=\/wp\/v2\/media\/138603"}],"wp:attachment":[{"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=138602"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=138602"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=138602"},{"taxonomy":"author","embeddable":true,"href":"https:\/\/cardiologynownews.org\/index.php?rest_route=%2Fwp%2Fv2%2Fppma_author&post=138602"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}