Department of Medicine, John H. Stroger Jr Hospital of Cook County, Chicago, IL, USA.
Department of Biomedical Science, Seoul National University Graduate School, Seoul, South Korea.
J Interv Card Electrophysiol. 2022 Sep;64(3):763-771. doi: 10.1007/s10840-022-01168-2. Epub 2022 Mar 8.
Landmark trials have shown superiority of ablative therapy over medical therapy in certain subpopulation with atrial fibrillation (AF). Previous studies have demonstrated an association between weight loss and reduced rates of recurrence of AF after ablation. The objective of this study is to determine if weight loss reduces the recurrence of AF after ablation.
An extensive literature search and systematic review of studies of weight loss on recurrence of AF after ablative therapy was performed. Risk ratio (RR) and 95% confidence intervals were measured for weight loss group versus control group in each study, and comparative analysis as well as subgroup analysis was made.
Eight studies with a total of 1,425 patients were included. Overall, studies of patients who lost weight demonstrated lower recurrence of AF (RR 0.35; 95% CI 0.18-0.67). However, subgroup analysis of studies which included patients who lost ≥10% weight loss from baseline showed lower recurrence of AF (RR 0.18; 95% 0.03-0.89), whereas studies which included patients with <10% weight loss did not (RR 1.00; 95% 0.51-1.96). Studies of patients who had less than 12-month history of AF (RR 0.24; 95% CI 0.11-0.57) and those who lost weight prior to ablation (RR 0.40; 95% CI 0.20-0.79) also had lower recurrence of AF.
Weight loss is associated with lower long-term recurrence of AF after ablative therapy. Studies of patients with ≥10% weight loss, less than 12-month history of AF, and weight loss prior to ablation experience lower recurrence of AF.
landmark 试验表明，在某些特定的房颤（AF）亚群中，消融治疗优于药物治疗。先前的研究已经证明了体重减轻与消融后 AF 复发率降低之间存在关联。本研究旨在确定体重减轻是否会降低消融后 AF 的复发率。
对消融治疗后体重减轻对 AF 复发的影响进行了广泛的文献检索和系统评价。对每个研究中体重减轻组与对照组的风险比（RR）和 95%置信区间进行了测量，并进行了对比分析和亚组分析。
纳入了 8 项共 1425 例患者的研究。总体而言，体重减轻的患者研究表明 AF 复发率较低（RR 0.35；95%CI 0.18-0.67）。然而，对纳入基线体重减轻≥10%的患者的研究进行亚组分析显示，AF 复发率较低（RR 0.18；95%CI 0.03-0.89），而纳入体重减轻<10%的患者的研究则没有（RR 1.00；95%CI 0.51-1.96）。对 AF 病史少于 12 个月的患者（RR 0.24；95%CI 0.11-0.57）和在消融前减轻体重的患者（RR 0.40；95%CI 0.20-0.79）的研究也显示出较低的 AF 复发率。
体重减轻与消融后 AF 的长期复发率降低相关。对于体重减轻≥10%、AF 病史少于 12 个月以及在消融前减轻体重的患者，AF 复发率较低。
