A randomized comparison of comprehensive weight loss intervention vs. usual care on recurrences of atrial fibrillation in obese patients after catheter ablation: HOBIT-AF trial.
Kristýna Koščálová, Peter Novodvorský, Iva Jakubíková et al.
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In 30 seconds
The HOBIT-AF randomized controlled trial tested whether a comprehensive weight-loss intervention reduced atrial fibrillation or atrial tachycardia (AF/AT) recurrence after catheter ablation in obese patients. It randomized 167 participants to intervention or usual care, with treatment from 3 to 18 months after ablation. The intervention group lost a mean 6.8 ± 7.0% of initial body weight and improved metabolic parameters, but AF/AT recurrence-free survival was comparable: 70.4% versus 69.6%. The trial therefore found no reduction in recurrence despite weight loss.
Key findings
- The intervention group achieved a mean reduction of 6.8 ± 7.0% of initial body weight, with improved metabolic parameters.
- AF/AT recurrence-free survival was 70.4% with intervention and 69.6% with usual care.
- AF/AT burden change was 0.6 ± 2.5% in the active group and -0.9 ± 1.8% in the control group.
Why it matters
Weight reduction improved metabolic measures in this post-ablation population, but those benefits did not translate into fewer observed AF/AT recurrences compared with usual care. The findings distinguish improvement in weight and metabolic profile from rhythm outcomes and suggest that recurrence after ablation may not be further reduced by this intervention in the studied setting.
What to keep in mind
The study involved obese patients with predominantly paroxysmal AF after catheter ablation; the authors suggest low AF burden after ablation may have limited the potential for further improvement.