People with an irregular heart rhythm could
see an improvement in symptoms if they lose weight in addition to managing their
other heart risks, says a new study.
Researchers found that people who lost more than 30 pounds and kept their other
health conditions in check saw greater improvements in atrial fibrillation
symptoms than those who just managed their other health conditions without
trying to lose weight.
"Risk factor management is a crucial component of managing atrial
fibrillation," Dr Prashanthan Sanders, the study's lead author from the
Royal Adelaide Hospital in Australia, said. "I think that's what the public
needs to be aware of and it's not out there yet," he added. Atrial
fibrillation (AF) is a type of rhythm disorder affecting the heart's upper
chambers. It can be caused by a number of issues – including heart attacks,
infections and heart valve problems.
Obesity is a risk factor for AF, as are high blood pressure, high cholesterol
and diabetes. Approximately five million people were diagnosed with AF in 2010.
That number is expected to grow to about 12 million cases per year by 2030,
according to one recent study, people with AF can experience racing and
uncomfortable heartbeats, weakness, blood pressure problems, chest pains and
Sanders and his colleagues recruited 150
people with AF to participate in the study to see whether weight loss and
well-managed risk factors helped ease symptoms. The results were published in
the Journal of the American Medical Association. The participants were patients
between the ages of 21 and 75 at the Centre for Heart Rhythm
Disorders at the University of Adelaide.
They were also all overweight. At the beginning of the study in June 2010, the
participants were randomly assigned to the weight loss group or to a comparison
group. Over a period of eight weeks, those in the weight loss group were put on
low-calorie diets, which were eventually replaced with low-glycaemic index
meals. They were also told to exercise three times a week for 20 minutes.
That eventually increased to 45 minutes three times per week. Both groups got
aggressive management of other risk factors, including medications to control
blood pressure, cholesterol and blood sugar, as needed. The participants
assigned to the comparison group received nutrition and exercise advice as
well. The participants were followed for an average of 15 months. At the
beginning of the study, participants in each group scored – on average –
between 21 and 22 on a scale that measures AF symptoms.
The scale ranges from 3.25, for a single
episode of symptoms lasting a few minutes, to 30, for continuous and intense
symptoms lasting more than a couple of days. At the end of the study, members
of the weight loss group had dropped an average of 33 pounds each. And their AF
symptom scale scores fell to about 9. That compared to an average score of
about 19 among participants in the comparison group, whose average weight loss
was about 12 pounds each. Sanders told Reuters Health that the improvement
observed in the weight loss group would also be noticeable to patients.
Not needing the procedure
"Most of those patients we included were on our waiting list to undergo
ablation procedures to eliminate their atrial fibrillation," he said,
adding that most patients didn't end up needing the procedure after the study. Dr
Bruce Lindsay told Reuters Health that he's not surprised by the study's
findings. He's section head of cardiac electrophysiology and pacing at the
Cleveland Clinic in Ohio.
"I think there has been some knowledge in the community that obesity is
linked to atrial fibrillation," Lindsay said."When I see patients who are overweight and I'm talking to
them about the options for treatment, I try to make it clear that there are
things we can do to help them but there are other things they can do," he
Those things include weight loss. Sanders said that people with AF should
address their risk factors and talk with their doctors about weight loss
options, including programmes in their local community.
Lindsay said programmes that focus on lifestyle changes, such as Weight Watchers,
are best. Sanders said there is no easy way to lose weight, but people with AF
are encouraged to keep going as their symptoms improve. "When they start
seeing the effect of losing weight, they get motivated," he said.