Evidence based medical wellness for active people from a doc who walks the walk

Atrial Fibrillation is a life style disease, and what to do about it


I just finished reading an article (here) about managing atrial fibrillation with weight loss.  The article was intense, and I had to take out my highlighter and pen to keep track of the details.  But none the less it was a good one with lots of great take points! Now, for the scientists in the bunch, don’t go all hater on me. It was a small study with 15o participants, but the results were stunning. Patients were divided into two groups, the intervention group and the control group.  The conclusion:

Basically, Atrial Fibrillation can prevented and managed with intensive life style modifications, in addition to medications.

The intervention group had fewer symptoms of atrial fibrillation and fewer episodes than the control group. But, it ain’t easy.  Here is what the “intervention” group had/did:

  • Physician led weight loss. The participants ate a very low calorie diet from 800-1200 kcal per day.  (Ha! That sounds pretty rough!) They were given two meal replacements per day, and the third was to be high protein with low glycemic level foods. This lasted for two months, and then were replaced with low glycemic meals for 13 months.
  • An exercise program consisting of 20 minutes 3 times per week, and then increased to 45 minutes per day 3 times per week. Exercise was typically walking.
  • The intervention group had a clinic face to face visit every 3 months, and were provided 24 hour e-mail and telephone support. The patients could schedule additional visits if desired.
  • Participants had to keep a diet, exercise and blood pressure diary.

Both control and intervention patients received intense counseling and treatment of cholesterol, blood pressure, glucose levels, sleep apnea, and were encouraged to decrease alcohol consumption. Both groups lost weight, but the intervention group lost a lot more.  The intervention group lowered their blood pressure, cholesterol  and alcohol consumption more than the control group.

Here’s the clincher: the intervention group had fewer symptoms of a-fib, and the symptoms were less intense than the control group.  In addition, the intervention group had fewer episodes of atrial fibrillation.

Great! So here is the check list of what patients should do (seriously!):

  • Lose weight with a strict diet and stick to it for FIFTEEN MONTHS!
  • Exercise at least 135 minutes per week.
  • Work with their doctor to lower their blood pressure and cholesterol levels.  (Some of this will occur just by losing weight.)
  • Decrease or stop alcohol use.
  • Get screened for sleep apnea, and get it treated if necessary.
  • Have a physician that is willing to participate in this intense work and is available by email/phone if needed.

Who’s in? I am if anyone is interested…

Author: PookieMD

I am a board certified internal medicine physician. I love medicine and seek to bring evidence based medicine to the fitness and wellness world.

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