Arrhythmias & electrophysiologyRandomised controlled trial
Catheter Ablation vs Lifestyle Modification With Antiarrhythmic Drugs to Treat Atrial Fibrillation
- Randomised controlled trial
- multicentre
- non-inferiority
Authors' conclusion
Despite important metabolic improvements associated with LFM, CA was superior to LFM combined with AADs in improving freedom from AF at 1 year in patients with AF and obesity.
Study context
- Population
- Patients with paroxysmal or persistent atrial fibrillation (AF) and body mass index (BMI) 30–40 kg/m²203 analysed
- Participants
- 212 patients
- Comparison
- Lifestyle modification with antiarrhythmic drugs vs catheter ablation
- Catheter ablation (CA)n = 100reference
- Lifestyle modification (LFM)+AADn = 103
- Primary endpoint
- AF freedom (absence of any AF episode lasting >30 s; 3-month blanking period)
- Follow-up
- 12 months after randomization
Primary result
As reported in the abstract
AF freedom · 12 months
LFM+AAD vs CA: P for non-inferiority = 0.99 · CA vs LFM+AAD: P for superiority < 0.001
Secondary outcomes
| Outcome | CA | LFM+AAD | P value |
|---|---|---|---|
| Weight change | −0.35 ± 4.8 kg | −6.4 ± 7.9 kg | P < 0.001 |
HbA1c
- Decrease in HbA1c more significant with LFM+AAD than CA
Original publication
Catheter Ablation vs Lifestyle Modification With Antiarrhythmic Drugs to Treat Atrial Fibrillation. J Am Coll Cardiol. Published 8 July 2025. doi:10.1016/j.jacc.2025.04.042
Summarised from the published abstract; every number is checked against it