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Published on: February 26, 2013
Weight Loss in Older Patients With Persistent Atrial Fibrillation: The LOSE-AF Randomized Clinical Trial
Matteo Sclafani1,2, Marco Spartera1, Yasmin Esmati1
1Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, John Radcliffe Hospital, Oxford, United Kingdom.
JAMA
|May 20, 2026
Summary
Weight loss interventions in older adults with atrial fibrillation (AF) led to significant weight reduction but did not improve AF symptoms. This study found no safety concerns, suggesting weight management is safe for this demographic.
Area of Science:
- Cardiology
- Geriatrics
- Weight Management
Background:
- Excess body weight is a significant risk factor for atrial fibrillation (AF).
- Clinical guidelines recommend weight loss for patients with obesity and AF.
- Existing evidence on weight loss interventions primarily involves younger populations, with limited data on older adults and potential risks like frailty.
Purpose of the Study:
- To evaluate the safety and effectiveness of weight loss interventions in older patients diagnosed with overweight and AF.
- To determine if a low-calorie diet and behavioral support program impacts AF symptom severity in elderly individuals.
Main Methods:
- A randomized clinical trial involving 118 participants aged 60-85 years with overweight and AF.
- Participants were assigned to either an 8-month low-calorie diet and behavioral support program or usual care.
- The primary outcome was the change in Atrial Fibrillation Severity Scale (AFSS) symptom severity score at 8 months.
Main Results:
- The intervention group achieved a significant mean weight loss of 9.7% compared to 3.1% in the control group (P < .001).
- No significant differences were observed in AFSS symptom severity scores between the groups (P = .43).
- No significant effects were noted on physical performance, AF burden, cardiac imaging, blood pressure, lipids, or need for repeat cardioversion/ablation. No serious adverse events were reported.
Conclusions:
- In older adults with overweight and persistent AF, a low-calorie diet and behavioral support program effectively reduces weight without safety concerns.
- This intervention did not demonstrate significant improvements in AF symptoms, AF burden, or cardiac remodeling within the 8-month study period.
- Further research may be needed to explore long-term effects or alternative strategies for managing AF in older, overweight populations.
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