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Updated: Jan 6, 2026

Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

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Published on: February 26, 2013

Aggressive Risk Factor Reduction Study for Atrial Fibrillation Implications for Ablation Outcomes: The ARREST-AF

Rajeev K Pathak^1,2, Adrian D Elliott¹, Dennis H Lau¹

¹Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia.

JAMA Cardiology

|October 29, 2025

Summary

This summary is machine-generated.

Aggressive lifestyle and risk factor management significantly reduced atrial fibrillation (AF) recurrence after catheter ablation. This approach is crucial for maintaining sinus rhythm post-ablation in patients with elevated BMI and cardiometabolic risk factors.

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Area of Science:

Cardiology
Electrophysiology
Preventive Medicine

Background:

Atrial fibrillation (AF) ablation outcomes often decline over time.
Observational studies suggest lifestyle modification improves outcomes, but randomized trial evidence is limited.

Purpose of the Study:

To assess the impact of risk factor and weight management on maintaining sinus rhythm after AF ablation.

Main Methods:

A multicenter, randomized clinical trial involving 122 patients with symptomatic AF, elevated BMI (≥27), and cardiometabolic risk factors.
Patients were randomized to lifestyle and risk factor management (LRFM) or usual care (UC) for 12 months post-ablation.

Main Results:

The LRFM group showed a significantly higher proportion of patients free from AF at 12 months (61.3% vs. 40%, P=.03).
LRFM led to a 47% reduction in arrhythmia recurrence hazard and significant improvements in AF symptom severity, body weight, waist circumference, and systolic blood pressure.

Conclusions:

Aggressive risk factor management is effective in reducing arrhythmia recurrence after AF catheter ablation.
This strategy is vital for long-term rhythm control in patients with AF, obesity, and cardiometabolic risk factors.