Aggressive lifestyle management helps improve success rate of AF after ablation

Results of the ARREST AF (Aggressive risk factor reduction study for atrial fibrillation) study were presented by Rajeev K Pathak (Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia) at HRS 2014. The study, winner of HRS’s Eric Prystowsky abstract award in the category of clinical research, demonstrated that patients who underwent aggressive management of cardiometabolic risk factors had nearly a five-fold greater probability of arrhythmia free survival (95% confidence interval: 2.04-11.4, p<0.001). Pathak, who works as a research fellow in the laboratory of Prash Sanders in Adelaide, Australia, told delegates: “The long-term outcomes of atrial fibrillation ablation demonstrate attrition. We hypothesised that this attrition is due to a progressive substrate promoted by traditional cardiovascular risk factors.” Therefore, he said, this study was designed to evaluate the impact of risk factor and weight management on the outcomes of atrial fibrillation ablation. A previous study, led by Sanders (Hany Abed et al, JAMA 2013;310(19):2050-2060), found that a structured weight management programme for highly symptomatic patients with atrial fibrillation reduced symptom burden and severity and reduced Defibrillation testing may not be necessary