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Table 1: Randomized clinical studies about risk factors control and their results in patients with atrial fibrillation. |
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Study |
Objective |
Impact on AF’s behavior |
Other findings |
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Legacy11 355 patients with AF Follow-up 48.4 ± 18.2 months |
Body weight reduction (> 10 vs 3-9 vs < 3% reduction) and risk factor’s management |
Reduction of the frequency, duration and severity of AF’s symptoms
Higher AF-free survival (86.2 vs 65.5 vs 39.6%) |
Reduction of the left atrium’s indexed volume Reduction of interventricular septum’s thickness Reduction of the left ventricle’s end-diastolic diameter Reduction of high sensitivity C-reactive protein
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Reverse-AF12 Same patients as in the Legacy study11 Follow-up 48 4 ± 18.2 months |
Body weight reduction (> 10 vs 3-9% vs < 3% reduction) and risk factor’s management |
Lower progression to AF’s persistent forms (3 vs 32 vs 41%) Higher AF’s reversion from persistent to paroxismal forms (88 vs 49 vs 26%) |
Reduction of the left atrium’s indexed volume Reduction of interventricular septum’s thickness Reduction of the left ventricle’s end-diastolic diameter Reduction of high sensitivity C-reactive protein |
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Weight reduction in cardiometabolic risk27 150 patients with paroxismal or persistent AF Follow-up 15 months |
Body weight reduction and risk factors control |
Reduction in frequency, severity, impact and duration of AF’s symptoms |
Reduction of interventricular septum’s thickness Left atrium’s area reduction |
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Race 328 250 patients with AF and HF119 multiple combined therapies, 126 conventional therapy Follow-up 12 months |
Risk factors control vs conventional therapy |
Sinus rhythm in the risk factors control group 75 vs 63% with conventional therapy group Improvement of AF’s symptoms |
Improvement in systolic and diastolic blood pressure control Weight reduction, body mass index reduction. Lower total cholesterol levels, LDL, NT-proBNP and urinary sodium |
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Arrest-AF29 Patients submitted to AF ablation 149 Ablation + risk factor’s control 88 control group (ablation only) Follow-up 41.6 ± 14.2 months |
Risk factors control HBP, lipid, glycemic and sleep apnea control along with weight reduction, reduction of tobacco and alcohol use |
Reduction in the frequency, duration and severity of AF’s symptoms Higher AF-free survival after one or several procedures (87 vs 17.8%) |
Reduction of interventricular septum’s thickness Left atrium’s volume reduction |
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Cardio-Fit38 308 patients with FA Follow-up 49 ± 19 months |
High physical conditioning vs adequate vs low Physical conditioning gain during follow-up |
Reduction in the frequency, duration and severity of AF Higher AF-free survival in the high physical conditioning group (84 vs 76 vs 17%) |
Higher physical performance: higher weight reduction, lower blood pressure, LDL and triglyceride reduction, better glycemic control, lower high-sensitivity C reactive protein levels, left atrium’s volumen reduction |
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AF = atrial fibrillation. HF = heart failure. LDL = low density lipoprotein. HBP = High blood pressure. |
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