Randomised trial of app-led motivational support for patients with AF to promote weight loss (MOTIVATE-AF)

Atrial fibrillation (AF) is responsible for significant patient morbidity, and obesity is a major contributor to AF incidence and symptom burden. Weight loss has been shown to positively modify AF symptoms, but weight loss in a real-world population is often only temporary. This randomised study set out to examine if smartphone-based app technology could increase weight loss in a patient population with obesity and AF. Individuals were screened following outpatient referral to Leeds Teaching Hospitals NHS Trust for symptomatic AF. Block randomisation was performed to allocate the treatment groups to either clinical follow-up or app-based follow-up, with weight loss updates planned fortnightly. Patients randomised to clinical followup received nurse-led telephone calls every two weeks, while those in the app arm received automated reminder messages every two weeks. Final follow-up at six months included clinical and weight data and a quality-of-life questionnaire. Sixty-four patients underwent randomisation. No significant difference in weight loss was seen between the groups. Patient engagement was far more consistent in the telephone follow-up group. In conclusion, no significant difference in weight loss was seen between the two groups, despite patient education on the value of weight loss to improve their AF symptoms.