To evaluate the effects of an 8-month low-calorie diet and behavioral support program on atrial fibrillation (AF) severity and burden in older patients with persistent AF.
Approach:
Key Findings:
Patients in the intervention group lost 10% of body weight at 8 months compared to 3% in the control group.
AF symptom severity scores did not differ significantly between groups at 8 months (7.9 in intervention vs 8.9 in control).
No significant differences in AF burden, physical function, or cardiac remodeling were observed between groups.
Long-term follow-up showed persistent weight difference but no improvement in AF symptoms or need for additional interventions.
Interpretation:
Limitations:
The trial was open-label, which may introduce bias.
Recruitment and follow-up were affected by the COVID-19 pandemic.
Some secondary outcome assessments were incomplete.
The intervention produced moderate weight loss compared to larger reductions seen with pharmacologic therapy or bariatric surgery.
Nearly half of the enrolled patients had long-standing persistent AF, indicating a potentially treatment-resistant population.
