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Oct 18, 2017

Weight Loss and Exercise are Critical for Obese Patients with Atrial Fibrillation

Experts stress the importance of a healthy lifestyle for preventing and treating a common heart rhythm problem.

It’s never too late for patients with an abnormal heart rhythm to start exercising and losing weight, based on a recent paper that stresses the importance of physical activity and weight loss for the treatment of atrial fibrillation.

Published in the Journal of the American College of Cardiology, this paper reviewed the latest evidence on obesity and atrial fibrillation. Atrial fibrillation, often referred to as AFib, is the most common type of abnormal heart rhythm, which affects an estimated 5.2 million Americans. While obesity is a major risk factor for AFib, some studies suggest that obese adults with AFib live longer than other patients. Experts worry that this association, known as the obesity paradox, provides false reassurance for obese patients living with AFib.

After reviewing existing evidence, however, authors found significant flaws in past research on the obesity paradox and atrial fibrillation. As they explain in their recent paper, it’s unclear whether obesity truly protects patients with AFib or if the association is due to other factors, such as age or medication use. Additional research is needed to better understand how overweight and obesity impact outcomes for patients with atrial fibrillation.

What we do know, explain authors, is that exercise and weight loss can help prevent patients from ever developing atrial fibrillation. Obesity is a well-established risk factor for AFib, and studies suggest that losing weight can help reduce that risk.

Recent evidence also continues to show that exercise and weight loss improve outcomes for patients with established atrial fibrillation. For example, results of the CARDIOFIT study, which were first published in 2015, found that fitness reduces symptoms and recurrence of atrial fibrillation. A similar trial published in 2016 showed that an exercise training program reduces episodes of AFib. Studies have also linked weight loss to a nearly six-fold increase in arrhythmia-free survival.

The take-home message, according to authors, is that we should put little stake in the obesity paradox when it comes to health. A wealth of evidence shows that regular exercise and a healthy weight improve outcomes in patients with existing heart conditions. Taking steps towards a healthier lifestyle can have significant benefits for both AFib and overall health.

Read the full study in the Journal of the American College of Cardiology.

Questions for You to Consider

  • What is a healthy weight for me?
  • A few important tools can be used to determine if an individual is underweight, normal weight or overweight. The easiest tool is a Body Mass Index, which is calculated using height and weight to estimate levels of body fat. However, Body Mass Index is not always accurate, particularly among individuals with extremely high or low amounts of muscle. In these cases, measuring waist circumference is helpful in assessing weight, as a waist circumference greater than 35 inches for a woman or 40 inches for a man is considered unhealthy.
  • What is atrial fibrillation?

  • Atrial fibrillation is an irregular heart rhythm caused by abnormal, chaotic electrical impulses in the heart’s upper chambers, the atria. These electrical impulses, which interfere with the heart’s natural pacemaker, fire so rapidly the atria cannot beat with a regular rhythm or squeeze out blood effectively. Instead, they merely quiver while the ventricles, the heart’s lower chambers, beat rapidly.

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