Enhancing outcomes of atrial fibrillation ablation by built-in customized way of life interventions: a randomized managed trial

Background and goals:

Atrial fibrillation (AF) is related to varied way of life danger components. Their presence negatively impacts AF catheter ablation outcomes. This examine evaluates the efficacy of a nurse-led, built-in way of life programme on ablation outcomes.

Methods:

POP-AF is a potential, randomized, managed trial involving sufferers referred for his or her first AF ablation. Patients have been assigned in a 1:1 ratio to straightforward pre-ablation counselling by the treating electrophysiologist, or a nurse-led built-in way of life clinic, together with a house sleep apnea check, weight discount, alcohol discount, smoking cessation, and optimum hypertension and hypercholesterolemia therapy earlier than present process pulmonary vein isolation (PVI). The main endpoint was a composite of hospitalizations for repeat ablations and direct present cardioversions in an event-rate evaluation as much as 12 months after pulsed-field PVI.

Results:

A complete of 145 sufferers participated within the trial; 70 sufferers have been assigned to the management group, and 75 sufferers have been assigned to the built-in way of life therapy (ILT) group. The median age of sufferers was 62 years, 26% have been ladies, and 59% had persistent AF. Median ILT period was 5 months. The main endpoint occurred 52 instances (492/1000 patient-years) within the management group and 25 instances (240/1000 patient-years) within the ILT group (incidence relative danger [RR] 0.49, 95% confidence interval [CI] 0.30-0.78, P=0.004). The charges of repeat ablations (RR 0.43, 95% CI 0.18-0.94, P=0.045) and direct present cardioversions (RR 0.52, 95% CI 0.28-0.92, P=0.031) have been additionally decrease within the ILT group.

Conclusions:

Integrated way of life modification earlier than catheter ablation reduces each repeat ablations and direct present cardioversions by half till 12 months after index ablation.