Improving outcomes of atrial fibrillation ablation by integrated personalized lifestyle interventions: a randomized controlled trial.

Their presence negatively affects AF catheter ablation outcomes.

它们的存在对AF导管消融的结果产生负面影响。

This study evaluates the efficacy of a nurse-led, integrated lifestyle programme on ablation outcomes.

本研究评估了以护士为主导的综合生活方式计划对消融治疗结果的影响。

Methods

POP-AF is a prospective, randomized, controlled trial involving patients referred for their first AF ablation.

POP-AF 是一项前瞻性、随机、对照试验，涉及被推荐进行首次房颤消融的患者。

Patients were assigned in a 1:1 ratio to standard pre-ablation counselling by the treating electrophysiologist, or a nurse-led integrated lifestyle clinic, including a home sleep apnoea test, weight reduction, alcohol reduction, smoking cessation, and optimal hypertension and hypercholesterolaemia treatment before undergoing pulmonary vein isolation (PVI).

患者按1:1的比例分配，接受由治疗心律失常的电生理学家进行的标准消融前咨询，或接受由护士主导的综合生活方式诊所，包括家庭睡眠呼吸暂停测试、减重、减少饮酒、戒烟以及在进行肺静脉隔离（PVI）前的最佳高血压和高胆固醇治疗。

The primary endpoint was a composite of hospitalizations for repeat ablations and direct current cardioversions in an event-rate analysis up to 12 months after pulsed-field pulmonary vein isolation.

主要终点是重复消融和直流电复律住院的复合终点，在脉冲场肺静脉隔离后12个月内的事件率分析中进行评估。

Results

A total of 145 patients participated in the trial; 70 patients were assigned to the control group, and 75 patients were assigned to the integrated lifestyle treatment (ILT) group.

共有145名患者参与了这项试验；其中70名患者被分配到对照组，75名患者被分配到综合生活方式治疗（ILT）组。

The median age of patients was 62 years, 26% were women, and 59% had persistent AF.

患者的中位年龄为62岁，26%为女性，59%的患者有持续性房颤。

Median ILT duration was 5 months.

IL T治疗的中位持续时间是5个月。

The primary endpoint occurred 52 times (492/1000 patient-years) in the control group and 25 times (240/1000 patient-years) in the ILT group [incidencerelative risk (RR) 0.49, 95% confidence interval(CI) 0.30-0.78, P = .004].

对照组中主要终点事件发生了52次（每千患者年492次），而IL T组中发生了25次（每千患者年240次）[发生率相对风险（RR）0.49，95%置信区间（CI）0.30-0.78，P = .004]。

The rates of repeat ablations (RR 0.43, 95% CI 0.18-0.94, P = .045) and direct current cardioversions (RR 0.52, 95% CI 0.28-0.92, P = .031) were also lower in the ILT group.

在ILT组中，重复消融的比率（相对风险 RR 0.43，95% 置信区间 CI 0.18-0.94，P = .045）和直流电复律的比率（相对风险 RR 0.52，95% 置信区间 CI 0.28-0.92，P = .031）也较低。

Conclusions

Integrated lifestyle modification before catheter ablation reduces both repeat ablations and direct current cardioversions by half until 12 months after index ablation.

在导管消融前进行综合生活方式改变，可将重复消融和直流电复律的发生率在初次消融后12个月内减半。