Arrhythmias & electrophysiologyRandomised controlled trial
Aggressive Risk Factor Reduction Study for Atrial Fibrillation Implications for Ablation Outcomes
- Randomised controlled trial
- open-label
- multicentre
- 3 sites in Adelaide, South Australia
Authors' conclusion
Among patients with AF, elevated BMI, and 1 or more additional cardiometabolic risk factors, aggressive risk factor management reduced arrhythmia recurrence over the 12-month period after catheter ablation.
Study context
- Population
- Patients with nonpermanent symptomatic atrial fibrillation (AF) undergoing first-time catheter ablation, body mass index (BMI) ≥27 and ≥1 additional cardiometabolic risk factor
- Participants
- 122 patients
- Comparison
- Lifestyle and risk factor management vs usual care at AF ablation
- Lifestyle and risk factor management (LRFM)n = 62
- Usual care (UC)n = 60reference
- Primary endpoint
- Proportion of patients free from AF after ablation
- Follow-up
- 12 months
Primary result
Freedom from AF · 12 months after ablation
Hazard ratio
0.53
95% CI 0.32–0.89
Events by treatment group
LRFM vs UC
HR 0.53 (95% CI 0.32–0.89)
As reported in the abstract
Further findings
| Outcome | mean difference (95% CI) | |
|---|---|---|
| AF symptom severity · significantly improved with LRFM | −2.0 (−3.7 to −0.3) | |
| −4−202Difference (linear scale) |
| Outcome | mean difference (kg) (95% CI) | |
|---|---|---|
| Risk factor profile · 12 months — LRFM vs UC · body weight | −9.0 (−11.1 to −6.8) | |
| −15−10−505Difference, kg (linear scale) |
| Outcome | mean difference (cm) (95% CI) | |
|---|---|---|
| Risk factor profile · 12 months — LRFM vs UC · waist circumference | −7.0 (−9.4 to −4.5) | |
| −10−505Difference, cm (linear scale) |
| Outcome | mean difference (mm Hg) (95% CI) | |
|---|---|---|
| Risk factor profile · 12 months — LRFM vs UC · SBP | −10.8 (−16.1 to −5.5) | |
| Risk factor profile · 12 months — LRFM vs UC · DBP, no difference | −3.5 (−7.2 to 0.2) | |
| −20−10010Difference, mm Hg (linear scale) |
Original publication
Aggressive Risk Factor Reduction Study for Atrial Fibrillation Implications for Ablation Outcomes. JAMA Cardiol. Published 1 December 2025. doi:10.1001/jamacardio.2025.4007
Summarised from the published abstract; every number is checked against it