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Impact of a nurse‐led limited risk factor modification program on arrhythmia outcomes in patients with atrial fibrillation undergoing catheter ablation
Author(s) -
Yaeger Amaryah,
Keenan Brendan T.,
Cash Nancy R.,
Parham Tara,
Deo Rajat,
Frankel David S.,
Schaller Robert D.,
Santangeli Pasquale,
Nazarian Saman,
Supple Gregory E.,
Arkles Jeffrey,
Kumareswaran Ramanan,
Hyman Matthew C.,
Riley Michael P.,
Garcia Fermin C.,
Lin David,
Epstein Andrew E.,
Callans David J.,
Mora Jorge I.,
Amaro Anastassia,
Schwab Richard,
Pack Allan,
Marchlinski Francis E.,
Dixit Sanjay
Publication year - 2020
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.14336
Subject(s) - medicine , atrial fibrillation , catheter ablation , body mass index , cardiology , ablation , obstructive sleep apnea , risk factor
Background We have previously demonstrated the feasibility of a nurse‐led risk factor modification (RFM) program for improving weight loss and obstructive sleep apnea (OSA) care among patients with atrial fibrillation (AF). Objective We now report its impact on arrhythmia outcomes in a subgroup of patients undergoing catheter ablation. Methods Participating patients with obesity and/or need for OSA management (high risk per Berlin Questionnaire or untreated OSA) underwent in‐person consultation and monthly telephone calls with the nurse for up to 1 year. Arrhythmias were assessed by office ECGs and ≥2 wearable monitors. Outcomes, defined as Arrhythmia control (0‐6 self‐terminating recurrences, with ≤1 cardioversion for nonparoxysmal AF) and Freedom from arrhythmias (no recurrences on or off antiarrhythmic drugs), were compared at 1 year between patients undergoing catheter ablation who enrolled and declined RFM. Results Between 1 November 2016 and 1 April 2018, 195 patients enrolled and 196 declined RFM (body mass index, 35.1 ± 6.7 vs 34.3 ± 6.3 kg/m 2 ; 50% vs 50% paroxysmal AF; P = NS). At 1 year, enrolled patients demonstrated significant weight loss (4.7% ± 5.3% vs 0.3% ± 4.4% in declined patients; P < .0001) and improved OSA care (78% [n = 43] of patients diagnosed with OSA began treatment). However, outcomes were similar between enrolled and declined patients undergoing ablation (arrhythmia control in 80% [n = 48] vs 79% [n = 38]; freedom from arrhythmia in 58% [n = 35] vs 71% [n = 34]; P = NS). Conclusion Despite improving weight loss and OSA care, our nurse‐led RFM program did not impact 1‐year arrhythmia outcomes in patients with AF undergoing catheter ablation.