Improving outcomes of AF ablation by integrated personalized lifestyle interventions: rationale and design of the prevention to improve outcomes of PVI (POP) trial

Vermeer, Jasper; Vinck, Tineke; Louw, Bianca de; Slingerland, Stacey; Veer, Marcel van ’t; Regis, Marta; Jansen, Jos-Marien; Heuvel, Edwin van den; Dekker, Lukas

doi:10.1007/s00392-023-02185-5

Cited by 4 publications

(1 citation statement)

References 39 publications

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“…The forthcoming POP trial might provide more insight into the potential influence of weight reduction on the outcomes of AF ablation. 29 …”

Section: Discussionmentioning

confidence: 99%

Body mass index and pulmonary vein isolation: real-world data on outcomes and quality of life

Vermeer,

Houterman,

Medendorp

et al. 2024

Europace

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Aims Increasing numbers of overweight and obese patients undergo pulmonary vein isolation (PVI), despite the association between higher body mass index (BMI) and adverse PVI outcomes. Evidence on complications and quality of life in different bodyweight groups is limited. This study aims to clarify the impact of BMI on repeat ablations, periprocedural complications, and changes in quality of life. Methods and results This multi-centre study analysed prospectively collected data from 15 ablation centres, covering all first-time PVI patients in the Netherlands from 2015 to 2021. Patients were categorized by BMI: normal weight (18.5–24.9 kg/m2), overweight (25–29.9 kg/m2), and obesity (≥30 kg/m2). Quality of life was assessed using the Atrial Fibrillation Effect on QualiTy-of-life questionnaire at baseline and 1-year post-PVI. Among 20 725 patients, 30% were of normal weight, 47% overweight, and 23% obese. Within the first year after PVI, obese patients had a higher incidence of repeat ablations than normal-weighing and overweight patients (17.8 vs. 15.6 and 16.1%, P < 0.05). Obesity was independently associated with repeat ablations (odds ratio 1.15; 95% confidence interval 1.01–1.31, P = 0.03). This association remained apparent after 3 years. Complication rates were 3.8% in normal weight, 3.0% in overweight, and 4.6% in obese, with weight class not being an independent predictor. Quality of life improved in all weight groups post-PVI but remained lowest in obese patients. Conclusion Obesity is independently associated with a higher rate of repeat ablations. Pulmonary vein isolation is equally safe in all weight classes. Despite lower quality of life among obese individuals, substantial improvements occur for all weight groups after PVI.

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“…The forthcoming POP trial might provide more insight into the potential influence of weight reduction on the outcomes of AF ablation. 29 …”

Section: Discussionmentioning

confidence: 99%

Body mass index and pulmonary vein isolation: real-world data on outcomes and quality of life

Vermeer,

Houterman,

Medendorp

et al. 2024

Europace

Self Cite

View full text Add to dashboard Cite

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Effect of supervised exercise training on cardiovascular function in patients with intermittent claudication: a systematic review and meta-analysis of randomized controlled trials

Xiao,

Li,

Zhang

et al. 2024

Clin Res Cardiol

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Obstructive sleep apnea in the patient with atrial fibrillation: current knowledge and remaining uncertainties

Lyons

2023

Current Opinion in Pulmonary Medicine

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Purpose of review Obstructive sleep apnea (OSA) is highly prevalent in patients with atrial fibrillation and plays a causal role for OSA in the pathogenesis of atrial fibrillation. The presence of OSA in atrial fibrillation is associated with increased symptom burden and increased risk of hospitalizations. Furthermore, untreated OSA is associated with an increased risk of atrial fibrillation recurrence post ablation or cardioversion, and observational studies suggest that continuous positive airway pressure (CPAP) therapy can attenuate this risk. This review describes our current understanding of the relationship between OSA and atrial fibrillation with an emphasis on emerging evidence. Recent findings Recent studies have identified novel screening questionnaires, which may be superior to traditional questionnaires in identifying OSA in atrial fibrillation populations. Significant night-to-night variability in OSA severity has been shown in atrial fibrillation patients, which has implications for diagnostic testing. While several small, randomized control trials (RCTs) have not shown CPAP therapy to be effective in reducing atrial fibrillation burden, one RCT did show CPAP can attenuate the atrial substrate with implications for long-term outcomes. Summary Further RCTs, appropriately powered, and focused on well defined cohorts, are required to guide management decisions regarding screening and treatment of OSA in atrial fibrillation populations.

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Improving outcomes of AF ablation by integrated personalized lifestyle interventions: rationale and design of the prevention to improve outcomes of PVI (POP) trial

Cited by 4 publications

References 39 publications

Body mass index and pulmonary vein isolation: real-world data on outcomes and quality of life

Body mass index and pulmonary vein isolation: real-world data on outcomes and quality of life

Effect of supervised exercise training on cardiovascular function in patients with intermittent claudication: a systematic review and meta-analysis of randomized controlled trials

Obstructive sleep apnea in the patient with atrial fibrillation: current knowledge and remaining uncertainties

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