Effect of Complex Weight-reducing Interventions on Rhythm Control in Obese Subjects With Atrial Fibrillation

NCT ID: NCT04560387

Last Updated: 2020-10-30

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

160 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-09-21

Study Completion Date

2025-06-30

Brief Summary

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Obesity is a well-established risk factor for the development of atrial fibrillation (AF), while the reduction of body weight was shown to reduce the risk of AF. However, little is known about the effect of different weight-reducing interventions on AF burden. The study will evaluate the effect of a complex program aimed at weight reduction on AF burden in subjects after catheter ablation for AF and at least 1st degree obesity. This will be investigated in randomized study design and compared with patients receiving standard care without specific obesity-related intervention. The weight loss program will consist of diet, lifestyle and exercise counselling and, in selected subjects, also bariatric surgery in order to achieve a sustained weight loss of \>10% of initial body weight. Secondary aims include identification of patient phenotypes with the most benefits from weight reduction as well as elucidation of potential pathomechanisms linking obesity and AF, with the main focus being on low-grade inflammation. The project will help to define the optimal weight-reducing regimen in AF and to tailor the interventions to individual patient needs.

Detailed Description

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Conditions

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Atrial Fibrillation Obesity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Interventional

Physician-lead complex program of weight-reducing interventions including education, diet counselling and regular physical activity aimed at achieving and maintaining a 10% reduction of baseline body weight.

Bariatric surgery - sleeve gastrectomy in a subgroup of subjects with BMI \> 35 kg/m2, i.e. standard indication of bariatric surgery (patients with BMI \> 35 kg/m2 and a presence of metabolic or other complications).

Group Type EXPERIMENTAL

Physician-lead complex program of weight-reducing interventions

Intervention Type BEHAVIORAL

A structured motivational and goal directed program will be used for weight reduction involving physicians, nutritionists, educators and physiotherapists. Initially, based on the input data provided by the patient an individual nutritional plan will be designed with the aim of reducing caloric intake by 10%. Low-intensity aerobic exercise for 30 min will be prescribed 3-times a week with the aim of increasing the frequency to 5-times a week and participants will be offered the possibility to participate in regular physiotherapist-lead group exercises. Patients will be required to maintain a diet and physical activity diary. Regular reviews will be scheduled every 3-6 months according to the actual weight loss.

Bariatric surgery - sleeve gastrectomy

Intervention Type PROCEDURE

Bariatric surgery will be performed based on actual medical indication and independently of patient's participation in the study. Sleeve gastrectomy was selected as the currently most frequent restrictive type of bariatric surgery with a proven efficacy on weight reduction, metabolic status and low-grade inflammation

Conservative

Routine treatment of obesity

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Physician-lead complex program of weight-reducing interventions

A structured motivational and goal directed program will be used for weight reduction involving physicians, nutritionists, educators and physiotherapists. Initially, based on the input data provided by the patient an individual nutritional plan will be designed with the aim of reducing caloric intake by 10%. Low-intensity aerobic exercise for 30 min will be prescribed 3-times a week with the aim of increasing the frequency to 5-times a week and participants will be offered the possibility to participate in regular physiotherapist-lead group exercises. Patients will be required to maintain a diet and physical activity diary. Regular reviews will be scheduled every 3-6 months according to the actual weight loss.

Intervention Type BEHAVIORAL

Bariatric surgery - sleeve gastrectomy

Bariatric surgery will be performed based on actual medical indication and independently of patient's participation in the study. Sleeve gastrectomy was selected as the currently most frequent restrictive type of bariatric surgery with a proven efficacy on weight reduction, metabolic status and low-grade inflammation

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Paroxysmal or persistent AF scheduled for primary RF ablation
* BMI ≥30 kg/m2
* Age 18-70 years
* Informed consent to the study

Exclusion Criteria

* Previous ablation for AF
* Myocardial infarction, stroke or pulmonary embolism \< 3 months prior to inclusion
* left ventricular ejection fraction \< 40%
* Left atrium diameter \> 55 mm
* Active thyroid disease
* Chronic kidney disease stage IV-V (eGFR \< 0.5 ml/s)
* Chronic liver disease
* Active malignancy
* Inability to comply with study procedures
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Martin Haluzik

OTHER_GOV

Sponsor Role lead

Responsible Party

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Martin Haluzik

Prof. Martin Haluzik, DSc.

Responsibility Role SPONSOR_INVESTIGATOR

Locations

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Institute for Clinical and Experimental Medicine

Prague, , Czechia

Site Status RECRUITING

Countries

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Czechia

Central Contacts

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Kristyna Stolbova, MD

Role: CONTACT

+420 728 375 528

Facility Contacts

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Martin Haluzik, Prof. DSc.

Role: primary

+420261361111

References

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Stolbova K, Novodvorsky P, Jakubikova I, Dvorakova I, Mraz M, Wichterle D, Kautzner J, Haluzik M. Effect of Complex Weight-Reducing Interventions on Rhythm Control in Obese Individuals with Atrial Fibrillation Following Catheter Ablation: A Study Protocol. Adv Ther. 2021 Apr;38(4):2007-2016. doi: 10.1007/s12325-021-01667-0. Epub 2021 Mar 12.

Reference Type DERIVED
PMID: 33710588 (View on PubMed)

Other Identifiers

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NU20-02-00190

Identifier Type: -

Identifier Source: org_study_id