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Atrial Fibrillation Lifestyle Project (ALP)

Primary Purpose

Atrial Fibrillation Paroxysmal

Status

Unknown status

Phase

Not Applicable

Locations

Canada

Study Type

Interventional

Intervention

Risk Factor Management Consult

Diet Classes

Stress Management Classes

Exercise Classes

Home based exercise program

About this trial

This is an interventional treatment trial for Atrial Fibrillation Paroxysmal focused on measuring Non-permanent atrial fibrillation, Non-valvular atrial fibrillation, Nutrition, Diet, Exercise, Physical Activity, Sleep Apnea, Cardiovascular Risk, Obesity, Hypertension, Diabetes, Risk Factor Management

Eligibility Criteria

19 Years - 75 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

paroxysmal, non-permanent, non-valvular AF. Patients with high burden of AF will be admitted into the study ahead of low burden patients.
1. Low burden paroxysmal AF is defined as: ≥4 episodes of AF over the past 24 months; episodes terminate spontaneously within 7 days or via cardioversion within 48 hours of onset.
2. High burden paroxysmal AF is defined as: ≥ 4 episodes of AF over the past 6 months, with ≥ 2 episodes > 6 hours in duration; episodes terminate spontaneously within 7 days or via cardioversion within 48 hours of onset.
3. Early persistent AF is defined as: ≥ 2 episodes of AF over the past 24 months; episodes are successfully terminated via cardioversion within 7 days of onset.
BMI equal to or greater than 27 kg/m^2, or central obesity using abdominal circumference with ethnic specific values recommended by Canadian diabetes association.
one of hypertension or diabetes

Exclusion Criteria:

Permanent AF
Estimated survival < 2 years
Left ventricular ejection fraction < 40%
Weight > 300 lbs, treadmill cannot hold greater weights
Inability to walk one city block
Severe musculoskeletal or neurological problems making them unable to exercise safely
New York Heart Association class 3-4 heart failure
Severe aortic valve stenosis
Prior mitral valve surgery or severe stenosis or regurgitation
Hypertrophic cardiomyopathy
Patients with illnesses or medications that already cause atrial fibrillation on their own, such as pericarditis, high doses of prednisone, and hyperthyroidism
Any other absolute and relative contraindications to exercise testing
Inability to speak and understand English
In atrial fibrillation at time of baseline testing
Defibrillator present

Sites / Locations

Richmond Hospital Cardiac Rehabilitation
Richmond Health Services
Garratt Wellness Centre
Richmond Cardiology ClinicRecruiting
Gordon and Leslie Diamond Health Care Centre
Live Well Clinic
St. Paul's Healthy Heart Program

Arms of the Study

Arm 1

Arm 2

Arm Type

No Intervention

Experimental

Arm Label

Control

Intervention

Arm Description

Participants in the control arm will receive standard care.

Participants in the intervention group will receive risk factor management consultations and take part in 1-hour biweekly diet classes and stress management classes for the first 3 months. This will be followed by 3 months of 1-hour biweekly high intensity interval training exercise classes. At the 6-month time point, participants will be prescribed a home based exercise program and will have the option of participating in weekly group walking sessions. During the final 6 months, participants will use a step/activity tracker to track their steps and heart rate.

Outcomes

Primary Outcome Measures

Changes in frequency of atrial fibrillation

The frequency of AF will be measured with 48-hour Holter monitor recording, looking at percent of time in AF.

Changes in severity of atrial fibrillation

Assessed using the Canadian Cardiovascular Society Severity in Atrial Fibrillation Scale (CCS-SAF), and the Atrial Fibrillation Symptom Severity Scale (AFSS). The CCS-SAF categorizes severity of atrial fibrillation from Class 0 to Class 4, with 0 being asymptomatic and 4 being severe. On the AFSS, individual symptoms attributable to AF are scored on a five-point Likert scale, such that the total AFSS severity score ranges from 0 to 35, with higher scores indicating increased AFSS. These two scales will be used simultaneously to inform the severity of Atrial Fibrillation.

Changes in Quality of Life on SF36

The 36-item Short Form Survey Instrument (SF36) measures quality of life. Each question is scored on a Likert scale with varying ranges (0-3, 0-5, etc.). Using a score conversion toolkit, the score for each question is converted to a value out of 100, such that lower scores indicate lower quality of life and higher scores indicate a higher quality of life. Those scores out of 100 can be added to get a score out of 3600, but the quality of life is most often reported as a percent.

Secondary Outcome Measures

Changes in number of medications

Total number of all anti-arrhythmic agents, anti-hypertensive agents, diabetes and cholesterol lowering medications will be recorded and compared.

Systolic and Diastolic Blood Pressure

Measured in mmHg. For a normal reading, your blood pressure needs to show a top number (systolic pressure) that's between 90 and less than 120 and a bottom number (diastolic pressure) that's between 60 and less than 80.

Hemoglobin A1C

The hemoglobin A1c test tells you your average level of blood sugar over the past 2 to 3 months. It's also called HbA1c, glycated hemoglobin test, and glycohemoglobin. It is reported in percentages.

Body Mass Index

Body mass index (BMI) is a measure of body fat based on height and weight that applies to adult men and women. BMI is universally expressed in units of kg/m^2.

Waist Circumference

Waist circumference is an indicator of health risk associated with excess fat around the waist. A waist circumference of 102 centimetres (40 inches) or more in men, or 88 centimetres (35 inches) or more in women, is associated with health problems such as type 2 diabetes, heart disease and high blood pressure

Relative Fat Mass

Relative Fat Mass (RFM) is a measure for the estimation of overweight or obesity in humans. The ratio or the patient's height and waist measurements in meters is multiplied by 20 before being subtracted from a number (shown in bold below) that adjusts for differences in gender and height: RFM for adult males: 64 - (20 x height in meters divided waist circumference in meters) RFM for adult females:76 - (20 x height in metres divided by waist circumference in meters)

Low density lipoprotein

Low-density lipoprotein (LDL) is one of the body's lipoproteins and an important carrier of cholesterol. LDL is an important marker for the risk of developing heart disease. LDL cholesterol levels should be less than 100 mg/dL. Levels of 100 to 129 mg/dL are acceptable for people with no health issues but may be of more concern for those with heart disease or heart disease risk factors. A reading of 130 to 159 mg/dL is borderline high and 160 to 189 mg/dL is high.

Apnea hypopnea index

The Apnea Hypopnea Index (AHI) is the number of apneas or hypopneas recorded during the study per hour of sleep. It is generally expressed as the number of events per hour. Based on the AHI, the severity of obstructive sleep apnea is classified as follows: None/Minimal: AHI < 5 per hour Mild: AHI ≥ 5, but < 15 per hour Moderate: AHI ≥ 15, but < 30 per hour Severe: AHI ≥ 30 per hour

Metabolic equivalents (METs)

Fitness will be classified using metabolic equivalents (METs). One MET is defined as the amount of oxygen consumed while sitting at rest and is equal to 3.5 ml O2 per kg body weight x min. The energy cost of an activity can be determined by dividing the relative oxygen cost of the activity (ml O2/kg/min) x by 3.5. This study will measure metabolic equivalents achieved on exercise stress test.

Left Atrial Volume Index

The Left Atrial Volume Index (LAVI) is the left atrial volume relative to Body Surface Area (BSA), and is reported in mL/m^2. Ranges of LAVI Reference Range 16-28 Mildly Abnormal 29-33 Moderately Abnormal 34-39 Severely Abnormal ≥40

Diastolic Function Grade

here are four grades of diastolic dysfunction as described below. Echocardiography is the gold standard to diagnose diastolic dysfunction. Grade I (impaired relaxation): This is a normal finding and occurs in nearly 100% of individuals by the age of 60. Grade II (pseudonormal): This is pathological and results in elevated left atrial pressures. Grade III (reversible restrictive): This results in significantly elevated left atrial pressures. Grade IV (fixed restrictive): This indicates a poor prognosis and very elevated left atrial pressures.

Left Atrial Pressure

Left atrial pressure (LAP) can be estimated by measuring the systolic blood pressure and the maximum mitral regurgitation velocity by spectral Doppler provided that there is no significant gradient across the aortic valve. Left Atrial Pressure is reported in mmHg

Full Information

NCT ID

NCT03724383

First Posted

October 1, 2018

Last Updated

October 26, 2018

Sponsor

Teddi Orenstein Lyall

Collaborators

Vancouver Coastal Health, Vancouver Coastal Health Research Institute, University of British Columbia

1. Study Identification

Unique Protocol Identification Number

NCT03724383

Brief Title

Atrial Fibrillation Lifestyle Project

Acronym

ALP

Official Title

Atrial Fibrillation Lifestyle Project

Study Type

Interventional

2. Study Status

Record Verification Date

October 2018

Overall Recruitment Status

Unknown status

Study Start Date

September 6, 2018 (Actual)

Primary Completion Date

April 2020 (Anticipated)

Study Completion Date

April 2020 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title

Sponsor-Investigator

Name of the Sponsor

Teddi Orenstein Lyall

Collaborators

Vancouver Coastal Health, Vancouver Coastal Health Research Institute, University of British Columbia

4. Oversight

Studies a U.S. FDA-regulated Drug Product

Studies a U.S. FDA-regulated Device Product

Data Monitoring Committee

Yes

5. Study Description

Brief Summary

The objectives of the investigators are to demonstrate a reduction in frequency and symptoms of AF and improvements in cardiovascular risk factors following a lifestyle intervention in patients with paroxysmal AF. Participants will be randomized into control or intervention groups. The intervention will receive step trackers, diet counselling, an exercise program, and risk factor modification consultations. Controls will receive step trackers and care as usual. Testing will occur at baseline, six months, and one year.

Detailed Description

Sixty percent of cases of non-valvular AF are associated with other modifiable risk factors, including: obesity, diabetes, hypertension, or sleep apnea. Treating modifiable risk factors has been shown to improve morbidity and mortality in patients with AF. Treatment of AF with antiarrhythmic drugs or catheter ablation has not been shown to improve survival. Recently, small cohort studies combining exercise, diet, and antiarrhythmic medications and/or ablation have shown improvements in cardiovascular risk factors and reduction in AF symptoms and frequency. The aim of this study is to demonstrate a reduction in frequency and symptoms of AF and improvements in cardiovascular risk factors following a lifestyle intervention in patients with paroxysmal AF. This study uses a reproducible intensive supervised cardiac rehabilitation that includes exercise, diet, and risk factor modification for patients with paroxysmal, non-valvular AF. The investigators expect that a lifestyle intervention will show significant improvement in fitness and weight loss and improvements in AF symptoms and frequency, and cardiovascular risk factors when compared to a control group with paroxysmal AF and similar baseline characteristics who do not receive a diet and exercise program.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study

Atrial Fibrillation Paroxysmal

Keywords

Non-permanent atrial fibrillation, Non-valvular atrial fibrillation, Nutrition, Diet, Exercise, Physical Activity, Sleep Apnea, Cardiovascular Risk, Obesity, Hypertension, Diabetes, Risk Factor Management

7. Study Design

Primary Purpose

Treatment

Study Phase

Not Applicable

Interventional Study Model

Parallel Assignment

Model Description

This is a parallel-group randomized controlled trial. Consecutive patients meeting eligibility criteria that are seen for routine cardiology follow-up will be invited to participate in this study. Patients who accept the possibility of diet counseling and exercise program will be randomized and stratified to 'control arm' versus 'intervention arm.' The final study results will be reported after completion of one-year follow up. We will also carry out a mid-study data analysis at six-months. Forty patients will be randomized to control arm and 40 patients randomized to the intervention arm. Intervention will include Phase 1, a six month program including three months of diet counseling combined with home exercise, followed by three months (starting at week 13) of an in-hospital, Cardiac rehabilitation exercise program. Phase 2 of the intervention will include six months of home-based maintenance exercise and diet (starting at week 25). The entire intervention period will be one year.

Masking

InvestigatorOutcomes Assessor

Masking Description

The investigators involved in analyzing test results or treating patients are blinded to the participant's study group.

Allocation

Randomized

Enrollment

80 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title

Control

Arm Type

No Intervention

Arm Description

Participants in the control arm will receive standard care.

Arm Title

Intervention

Arm Type

Experimental

Arm Description

Intervention Type

Behavioral

Intervention Name(s)

Risk Factor Management Consult

Intervention Description

Participants may be referred to an Internist to control risk factor management - this may require monthly visits until risk factor targets have been met.

Intervention Type

Behavioral

Intervention Name(s)

Diet Classes

Intervention Description

Group nutrition sessions delivered two times per week (1 hr each), over a 3 month period (months 0 to 3 of intervention) delivered by a registered dietitian.

Intervention Type

Behavioral

Intervention Name(s)

Stress Management Classes

Intervention Description

Group sessions delivered two times per week (1 hr each), over a 3 month period (months 0 to 3 of intervention). Techniques taught will include awareness, coping, and relaxation strategies.

Intervention Type

Other

Intervention Name(s)

Exercise Classes

Intervention Description

Group sessions delivered two times per week (1 hr each), over 3 month period (months 3-6). Classes will include high intensity interval training, resistance training.

Intervention Type

Other

Intervention Name(s)

Home based exercise program

Intervention Description

The interval and resistance training program will mirror the supervised exercise.

Primary Outcome Measure Information:

Title

Changes in frequency of atrial fibrillation

Description

The frequency of AF will be measured with 48-hour Holter monitor recording, looking at percent of time in AF.

Time Frame

Baseline to 6 months and 1 year

Title

Changes in severity of atrial fibrillation

Description

Time Frame

Baseline to 6 months and 1 year

Title

Changes in Quality of Life on SF36

Description

Time Frame

Baseline to 6 months and 1 year

Secondary Outcome Measure Information:

Title

Changes in number of medications

Description

Total number of all anti-arrhythmic agents, anti-hypertensive agents, diabetes and cholesterol lowering medications will be recorded and compared.

Time Frame

Baseline and 1 year

Title

Systolic and Diastolic Blood Pressure

Description

Time Frame

Baseline, 6 months, 1 year

Title

Hemoglobin A1C

Description

The hemoglobin A1c test tells you your average level of blood sugar over the past 2 to 3 months. It's also called HbA1c, glycated hemoglobin test, and glycohemoglobin. It is reported in percentages.

Time Frame

Baseline, 6 months, 1 year

Title

Body Mass Index

Description

Body mass index (BMI) is a measure of body fat based on height and weight that applies to adult men and women. BMI is universally expressed in units of kg/m^2.

Time Frame

Baseline, 6 months, 1 year

Title

Waist Circumference

Description

Time Frame

Baseline, 6 months, 1 year

Title

Relative Fat Mass

Description

Time Frame

Baseline, 6 months, 1 year

Title

Low density lipoprotein

Description

Time Frame

Baseline, 6 months, 1 year

Title

Apnea hypopnea index

Description

Time Frame

Baseline, 6 months, 1 year

Title

Metabolic equivalents (METs)

Description

Time Frame

Baseline, 6 months, 1 year

Title

Left Atrial Volume Index

Description

Time Frame

Baseline,1 year

Title

Diastolic Function Grade

Description

Time Frame

Baseline, 1 year

Title

Left Atrial Pressure

Description

Time Frame

Baseline, 1 year

10. Eligibility

Sex

All

Minimum Age & Unit of Time

19 Years

Maximum Age & Unit of Time

75 Years

Accepts Healthy Volunteers

Eligibility Criteria

Inclusion Criteria: paroxysmal, non-permanent, non-valvular AF. Patients with high burden of AF will be admitted into the study ahead of low burden patients. Low burden paroxysmal AF is defined as: ≥4 episodes of AF over the past 24 months; episodes terminate spontaneously within 7 days or via cardioversion within 48 hours of onset. High burden paroxysmal AF is defined as: ≥ 4 episodes of AF over the past 6 months, with ≥ 2 episodes > 6 hours in duration; episodes terminate spontaneously within 7 days or via cardioversion within 48 hours of onset. Early persistent AF is defined as: ≥ 2 episodes of AF over the past 24 months; episodes are successfully terminated via cardioversion within 7 days of onset. BMI equal to or greater than 27 kg/m^2, or central obesity using abdominal circumference with ethnic specific values recommended by Canadian diabetes association. one of hypertension or diabetes Exclusion Criteria: Permanent AF Estimated survival < 2 years Left ventricular ejection fraction < 40% Weight > 300 lbs, treadmill cannot hold greater weights Inability to walk one city block Severe musculoskeletal or neurological problems making them unable to exercise safely New York Heart Association class 3-4 heart failure Severe aortic valve stenosis Prior mitral valve surgery or severe stenosis or regurgitation Hypertrophic cardiomyopathy Patients with illnesses or medications that already cause atrial fibrillation on their own, such as pericarditis, high doses of prednisone, and hyperthyroidism Any other absolute and relative contraindications to exercise testing Inability to speak and understand English In atrial fibrillation at time of baseline testing Defibrillator present

Central Contact Person:

First Name & Middle Initial & Last Name or Official Title & Degree

Amy RN Booth, MPH

Phone

6044046343

amy.booth@vch.ca

First Name & Middle Initial & Last Name or Official Title & Degree

Oliver Kostanski, MD

oliverkostanski@gmail.com

Overall Study Officials:

First Name & Middle Initial & Last Name & Degree

Teddi Orenstein Lyall, MD

Organizational Affiliation

University of British Columbia

Official's Role

Principal Investigator

Facility Information:

Facility Name

Richmond Hospital Cardiac Rehabilitation

City

Richmond

State/Province

British Columbia

ZIP/Postal Code

V6X 1A2

Country

Canada

Individual Site Status

Not yet recruiting

Facility Contact:

First Name & Middle Initial & Last Name & Degree

Andrew Jakubowski, MD

Phone

6042731555

atjakubowski@gmail.com

Facility Name

Richmond Health Services

City

Richmond

State/Province

British Columbia

ZIP/Postal Code

V6Y 3T6

Country

Canada

Individual Site Status

Not yet recruiting

Facility Contact:

First Name & Middle Initial & Last Name & Degree

Christina Salgado, RN

Phone

6042335614

chris.salgado@vch.ca

Facility Name

Garratt Wellness Centre

City

Richmond

State/Province

British Columbia

ZIP/Postal Code

V7C 3S9

Country

Canada

Individual Site Status

Not yet recruiting

Facility Contact:

Phone

(604) 204-2007

Facility Name

Richmond Cardiology Clinic

City

Richmond

State/Province

British Columbia

ZIP/Postal Code

V7C 5L9

Country

Canada

Individual Site Status

Recruiting

Facility Contact:

First Name & Middle Initial & Last Name & Degree

Teddi Orenstein Lyall, MD

Phone

6042731555

teddi.orenstein@vch.ca

Facility Name

Gordon and Leslie Diamond Health Care Centre

City

Vancouver

State/Province

British Columbia

ZIP/Postal Code

V5Z 1M9

Country

Canada

Individual Site Status

Not yet recruiting

Facility Name

Live Well Clinic

City

Vancouver

State/Province

British Columbia

ZIP/Postal Code

V6M 3W6

Country

Canada

Individual Site Status

Not yet recruiting

Facility Contact:

First Name & Middle Initial & Last Name & Degree

Ali Zentner, MD

Phone

6042693705

Facility Name

St. Paul's Healthy Heart Program

City

Vancouver

State/Province

British Columbia

ZIP/Postal Code

V6Z 1Y6

Country

Canada

Individual Site Status

Not yet recruiting

Facility Contact:

First Name & Middle Initial & Last Name & Degree

Saul Isserow, MD

Phone

6048227955

saul.isserow@vch.ca

12. IPD Sharing Statement

Plan to Share IPD

Citations:

PubMed Identifier

16639472

Citation

Dorian P, Cvitkovic SS, Kerr CR, Crystal E, Gillis AM, Guerra PG, Mitchell LB, Roy D, Skanes AC, Wyse DG. A novel, simple scale for assessing the symptom severity of atrial fibrillation at the bedside: the CCS-SAF scale. Can J Cardiol. 2006 Apr;22(5):383-6. doi: 10.1016/s0828-282x(06)70922-9.

Results Reference

background

PubMed Identifier

11028487

Citation

Dorian P, Jung W, Newman D, Paquette M, Wood K, Ayers GM, Camm J, Akhtar M, Luderitz B. The impairment of health-related quality of life in patients with intermittent atrial fibrillation: implications for the assessment of investigational therapy. J Am Coll Cardiol. 2000 Oct;36(4):1303-9. doi: 10.1016/s0735-1097(00)00886-x.

Results Reference

background

Citation

Hays, R. D.,&Stewart, A. L. (1992). Construct validity of MOS health measures. In A. L. Stewart&J. E. Ware (eds.), Measuring functioning and well-being: The Medical Outcomes Study approach (pp. 325-342), Durham, NC: Duke University Press.

Results Reference

background

PubMed Identifier

26733609

Citation

Malmo V, Nes BM, Amundsen BH, Tjonna AE, Stoylen A, Rossvoll O, Wisloff U, Loennechen JP. Aerobic Interval Training Reduces the Burden of Atrial Fibrillation in the Short Term: A Randomized Trial. Circulation. 2016 Feb 2;133(5):466-73. doi: 10.1161/CIRCULATIONAHA.115.018220. Epub 2016 Jan 5.

Results Reference

background

PubMed Identifier

24345399

Citation

Chugh SS, Havmoeller R, Narayanan K, Singh D, Rienstra M, Benjamin EJ, Gillum RF, Kim YH, McAnulty JH Jr, Zheng ZJ, Forouzanfar MH, Naghavi M, Mensah GA, Ezzati M, Murray CJ. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation. 2014 Feb 25;129(8):837-47. doi: 10.1161/CIRCULATIONAHA.113.005119. Epub 2013 Dec 17.

Results Reference

background

PubMed Identifier

11343485

Citation

Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, Singer DE. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001 May 9;285(18):2370-5. doi: 10.1001/jama.285.18.2370.

Results Reference

background

PubMed Identifier

24921459

Citation

Guo Y, Tian Y, Wang H, Si Q, Wang Y, Lip GYH. Prevalence, incidence, and lifetime risk of atrial fibrillation in China: new insights into the global burden of atrial fibrillation. Chest. 2015 Jan;147(1):109-119. doi: 10.1378/chest.14-0321.

Results Reference

background

PubMed Identifier

23084510

Citation

Lee GA, Stub D, Ling H. Atrial fibrillation in the elderly -- not a benign condition. Int Emerg Nurs. 2012 Oct;20(4):221-7. doi: 10.1016/j.ienj.2012.05.003. Epub 2012 Jul 4.

Results Reference

background

PubMed Identifier

21757483

Citation

Wolowacz SE, Samuel M, Brennan VK, Jasso-Mosqueda JG, Van Gelder IC. The cost of illness of atrial fibrillation: a systematic review of the recent literature. Europace. 2011 Oct;13(10):1375-85. doi: 10.1093/europace/eur194. Epub 2011 Jul 14.

Results Reference

background

PubMed Identifier

14966048

Citation

Stewart S, Murphy NF, Walker A, McGuire A, McMurray JJ. Cost of an emerging epidemic: an economic analysis of atrial fibrillation in the UK. Heart. 2004 Mar;90(3):286-92. doi: 10.1136/hrt.2002.008748. Erratum In: Heart. 2007 Nov;93(11):1472. Murphy, N [corrected to Murphy, N F].

Results Reference

background

PubMed Identifier

27609430

Citation

Macle L, Cairns J, Leblanc K, Tsang T, Skanes A, Cox JL, Healey JS, Bell A, Pilote L, Andrade JG, Mitchell LB, Atzema C, Gladstone D, Sharma M, Verma S, Connolly S, Dorian P, Parkash R, Talajic M, Nattel S, Verma A; CCS Atrial Fibrillation Guidelines Committee. 2016 Focused Update of the Canadian Cardiovascular Society Guidelines for the Management of Atrial Fibrillation. Can J Cardiol. 2016 Oct;32(10):1170-1185. doi: 10.1016/j.cjca.2016.07.591. Epub 2016 Sep 6. Erratum In: Can J Cardiol. 2017 Apr;33(4):552-553.

Results Reference

background

PubMed Identifier

21444879

Citation

Huxley RR, Lopez FL, Folsom AR, Agarwal SK, Loehr LR, Soliman EZ, Maclehose R, Konety S, Alonso A. Absolute and attributable risks of atrial fibrillation in relation to optimal and borderline risk factors: the Atherosclerosis Risk in Communities (ARIC) study. Circulation. 2011 Apr 12;123(14):1501-8. doi: 10.1161/CIRCULATIONAHA.110.009035. Epub 2011 Mar 28.

Results Reference

background

PubMed Identifier

24599014

Citation

Carlsson AC, Wandell P, Sundquist K, Johansson SE, Sundquist J. Effects of prescribed antihypertensives and other cardiovascular drugs on mortality in patients with atrial fibrillation and hypertension: a cohort study from Sweden. Hypertens Res. 2014 Jun;37(6):553-9. doi: 10.1038/hr.2014.32. Epub 2014 Mar 6.

Results Reference

background

PubMed Identifier

19808574

Citation

Eshoo S, Ross DL, Thomas L. Impact of mild hypertension on left atrial size and function. Circ Cardiovasc Imaging. 2009 Mar;2(2):93-9. doi: 10.1161/CIRCIMAGING.108.793190. Epub 2009 Jan 26.

Results Reference

background

PubMed Identifier

11357793

Citation

Tsang TS, Barnes ME, Bailey KR, Leibson CL, Montgomery SC, Takemoto Y, Diamond PM, Marra MA, Gersh BJ, Wiebers DO, Petty GW, Seward JB. Left atrial volume: important risk marker of incident atrial fibrillation in 1655 older men and women. Mayo Clin Proc. 2001 May;76(5):467-75. doi: 10.4065/76.5.467.

Results Reference

background

PubMed Identifier

14697466

Citation

Tsang TS, Barnes ME, Gersh BJ, Bailey KR, Seward JB. Risks for atrial fibrillation and congestive heart failure in patients >/=65 years of age with abnormal left ventricular diastolic relaxation. Am J Cardiol. 2004 Jan 1;93(1):54-8. doi: 10.1016/j.amjcard.2003.09.012.

Results Reference

background

PubMed Identifier

12466506

Citation

Wyse DG, Waldo AL, DiMarco JP, Domanski MJ, Rosenberg Y, Schron EB, Kellen JC, Greene HL, Mickel MC, Dalquist JE, Corley SD; Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Investigators. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med. 2002 Dec 5;347(23):1825-33. doi: 10.1056/NEJMoa021328.

Results Reference

background

PubMed Identifier

23419659

Citation

Neumann T, Wojcik M, Berkowitsch A, Erkapic D, Zaltsberg S, Greiss H, Pajitnev D, Lehinant S, Schmitt J, Hamm CW, Pitschner HF, Kuniss M. Cryoballoon ablation of paroxysmal atrial fibrillation: 5-year outcome after single procedure and predictors of success. Europace. 2013 Aug;15(8):1143-9. doi: 10.1093/europace/eut021. Epub 2013 Feb 17.

Results Reference

background

PubMed Identifier

27590435

Citation

Miyazaki S, Taniguchi H, Kusa S, Nakamura H, Hachiya H, Hirao K, Iesaka Y. Five-year follow-up outcome after catheter ablation of persistent atrial fibrillation using a sequential biatrial linear defragmentation approach: What does atrial fibrillation termination during the procedure imply? Heart Rhythm. 2017 Jan;14(1):34-40. doi: 10.1016/j.hrthm.2016.08.041. Epub 2016 Aug 30.

Results Reference

background

PubMed Identifier

26113406

Citation

Pathak RK, Elliott A, Middeldorp ME, Meredith M, Mehta AB, Mahajan R, Hendriks JM, Twomey D, Kalman JM, Abhayaratna WP, Lau DH, Sanders P. Impact of CARDIOrespiratory FITness on Arrhythmia Recurrence in Obese Individuals With Atrial Fibrillation: The CARDIO-FIT Study. J Am Coll Cardiol. 2015 Sep 1;66(9):985-96. doi: 10.1016/j.jacc.2015.06.488. Epub 2015 Jun 22.

Results Reference

background

PubMed Identifier

29049041

Citation

Hong KL, Glover BM. The impact of lifestyle intervention on atrial fibrillation. Curr Opin Cardiol. 2018 Jan;33(1):14-19. doi: 10.1097/HCO.0000000000000470.

Results Reference

background

PubMed Identifier

28694186

Citation

Elliott AD, Maatman B, Emery MS, Sanders P. The role of exercise in atrial fibrillation prevention and promotion: Finding optimal ranges for health. Heart Rhythm. 2017 Nov;14(11):1713-1720. doi: 10.1016/j.hrthm.2017.07.001. Epub 2017 Jul 8.

Results Reference

background

Citation

Jonasson D, Irvine S, Starkey S, Su S, Johal R, Sweeney P, et al. SCREENING FOR OBSTRUCTIVE SLEEP APNEA (OSA) IN ATRIAL FIBRILLATION (AF): WHAT'S THE BEST TEST? Can J Cardiol [Internet]. 2017 Oct 1 [cited 2018 Jan 24];33(10):S195.

Results Reference

background

Citation

Froelicher V, Myers J. Exercise and the Heart 5th edition. 5th ed. Pioli SF, editor. Philadelphia: Saunders; 2006.

Results Reference

background

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Atrial Fibrillation Lifestyle Project

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