A drug-free way to reduce the palpitations and dangers of A-fib

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Heart skips a beatA new study in JAMA shows that, aside from or in addition to well-known methods to control or correct atrial fibrillation (AF) drugs and electrical cardioversion/shock simply losing weight was found to significantly reduce both the frequency and duration/intensity of episodes of the condition.

The researchers were based at the Centre for Heart Rhythm Disturbances at the University of Adelaide in Australia. The authors randomized 150 overweight or obese AF patients to either standard care regarding weight control, or the study group: 75 patients received intensive weight control therapy, including a very low calorie diet, meal replacements, a written exercise plan, behavioral modification, and in-person clinic visits every 3 months; those in the routine care control group received written and verbal advice on nutrition and exercise.

The results showed that the study group (on intensive weight control) had substantial reductions in weight (on average, each lost about 10.5 kg or 23 lbs more than the control patients), and also in AF burden and severity (measured on a scale called Atrial Fibrillation Severity Scale) frequency of episodes and severity of symptoms, generally meaning palpitations. Seven-day cardiac rhythm strips were analyzed to document the reduced frequency of irregularity of heartbeat, and showed a decline in total duration of AF in the treatment group of 692 minutes, while the control group s symptoms increased by 419 minutes, over a mean of 15 months.

"This was a short-term effect. So it is likely as other risks drop with weight reduction, long term benefits are probably going to be accrued as well," Brian Olshansky, MD, emeritus professor of medicine at the University of Iowa in Iowa City told MedPage Today. He added, "it does appear that there is an actual physiological effect of weight on atrial fibrillation burden."

ACSHs Dr. Gilbert Ross added, Given the frequency of AF in the older population, and the major increased risk of stroke among those whose AF is poorly controlled, this is a hopeful result. Of course, it s not so easy to lose that much weight. But I d predict that any weight loss, with its beneficial effect on blood pressure especially, would have a similar reduction in AF burden albeit less effective,
depending on how much weight is actually lost.