Exercise, Diet May Keep Arrhythmia in Check

Atrial fibrillation patients who managed heart risk factors lived longer without developing irregular heartbeat

(RxWiki News) The world’s most common heart rhythm disorder may increase the odds of stroke, dementia and other health problems. A heart-healthy lifestyle, however, may reduce these risks.

A new study found that atrial fibrillation patients who had a surgery called ablation lived longer without an irregular heartbeat if they followed an aggressive program to reduce heart risk factors.

Sometimes referred to as quivering heart, atrial fibrillation is an irregular and often rapid heartbeat. It often leads to poor blood flow and clotting. A surgery called ablation has been shown to help atrial fibrillation. The operation deadens heart tissue that produces irregular electrical signals that cause atrial fibrillation. Even with ablation, however, irregular heartbeat can return.

Sarah Samaan, MD, FACC, cardiologist and physician partner at the Baylor Heart Hospital in Plano, TX, told dailyRx News that weight loss can make a huge difference with atrial fibrillation.

"Not only will it help to lower blood pressure, but it may also reduce the likelihood of sleep apnea," Dr. Samaan said. "Both of these common conditions are well known triggers of atrial fibrillation."

She added that exercising, avoiding excessive alcohol consumption, and not smoking are also important health measures that can keep the heart beating strong and steady.

Rajeev Pathak, MBBS, a cardiologist and electrophysiology fellow with the University of Adelaide, the Royal Adelaide Hospital and the South Australian Health and Medical Research Institute, led the new study.

"After a period of five years, arrhythmia-free survival rates for patients who undertook the risk management program were 87%, compared with less than 18% of the control group," Dr. Pathak said in a press statement.

Dr. Pathak and colleagues followed 149 patients with atrial fibrillation who had the corrective ablation procedure. The patients were all overweight, with body mass indexes (BMIs) of 27 or greater. BMI is a measure of body fat based on height and weight. A BMI over 25 is considered overweight. Anything higher than 30 is obese.

A total of 61 patients opted for risk factor management, while 88 were in a control group.

Dr. Pathak and team assessed all the patients every three to six months. Those in the risk management group also attended a risk management clinic every three months. The control group received information and saw their doctor but did not participate in a specific risk-reduction program.

The risk management program addressed several factors that may affect the heart, such as weight, blood pressure, blood sugar and cholesterol. The program also focused on smoking, alcohol use and sleep breathing problems like sleep apnea.

To reduce excess weight, high blood pressure and high cholesterol, patients in the program were required to maintain a diet and exercise diary. If patients in the program could not achieve healthy cholesterol and blood sugar levels, they were prescribed medication. Smokers in the program were offered support to help them quit. Those with sleep-disordered breathing were provided with therapies to improve breathing. These included positional therapy and continuous positive airway pressure (CPAP) machines.

Dr. Pathak and colleagues noted that risk factor management resulted in greater reductions in weight and blood pressure, as well as better blood sugar and cholesterol management, than in those in the control group.

“A structured physician-directed risk factor and weight management program resulted in significant improvement in the long-term outcomes,” they wrote.

An estimated 2.7 million Americans are living with atrial fibrillation, reports the American Heart Association. The condition mostly affects those older than 65.

Dr. Pathak said atrial fibrillation patients may not have the best possible outcomes by relying on a medical procedure alone.

“Our results show what a targeted management program can achieve," Dr. Pathak said in a press release. “This study should serve as a wake up call to physicians to begin prevention programs to reduce disease states rather than focus on their treatment only, and the good news is: it is never too late to start."

This study was published Dec. 2 in the Journal of the American College of Cardiology.

The National Health and Medical Research Council and the National Heart Foundation of Australia funded the research. The authors disclosed no conflicts of interest.

Review Date: 
December 14, 2014