{"id":"7ff071611eb5","type":"article","url":"https://hartvaat.nl/2026/11/04/gewichtsverlies-verbetert-metabole-profielen-maar-verlaagt-af-herhaling-niet-na-/","title":"Gewichtsverlies verbetert metabole profielen maar verlaagt AF-herhaling niet na ablatie — HOBIT-AF","title_en":"A randomized comparison of comprehensive weight loss intervention vs. usual care on recurrences of atrial fibrillation in obese patients after catheter ablation: HOBIT-AF trial.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["cardioloog"],"tags":[],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euag178","source_url":"https://doi.org/10.1093/europace/euag178","authors":["Kristýna Koščálová","Peter Novodvorský","Iva Jakubíková","Adam Ševčík","Adam Rafaj","Iveta Pleyerová","Kristýna Heidu","Jakub Štoček","Helena Kratochvílová","Luděk Horváth","Miloš Mráz","Jan Mareš","Dan Wichterle","Josef Kautzner","Martin Haluzík"],"significance":6,"published":"2026-11-11","source_date":"2026-11-04","image":"","kennis":["https://hartvaat.nl/kennis/antistolling/doac-versus-vka-keuze/","https://hartvaat.nl/kennis/atriumfibrilleren/ecg-herkenning-af/"],"congress":"","summary_en":"The HOBIT-AF randomized trial evaluated whether a comprehensive weight-loss program reduces atrial fibrillation (AF) recurrence in obese patients following catheter ablation. Over 15 months, the intervention group achieved a 6.8% mean weight loss with improved metabolic markers, yet AF burden and recurrence-free survival (70.4% vs 69.6%) were comparable to usual care. This indicates that while weight reduction benefits metabolic health, it does not significantly lower AF recurrence in patients who already have a low arrhythmia burden post-ablation.","created":"2026-11-05T02:14:13Z","updated":"2026-11-05T02:14:13Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In de gerandomiseerde HOBIT-AF-studie onderzochten onderzoekers of een intensief afvallingsprogramma de terugkeer van atriumfibrilleren (AF) voorkomt bij zware patiënten na een katheterablatie. Na 15 maanden daalde het lichaamsgewicht in de interventiegroep met 6,8% en verbeterden de metabole parameters, maar het AF-burden en de herhalingsvrije overleving (70,4% versus 69,6%) verschilden niet significant van de controlegroep. Voor de cardioloog betekent dit dat gewichtsverlies weliswaar metabole voordelen biedt, maar niet direct leidt tot minder AF-herhalingen bij patiënten met al een lage burden na ablatie.","abstract_original":"AIMS: Obesity is one of the strongest risk factors for the development of atrial fibrillation (AF), and its reduction is associated with the alleviation of AF burden. The HOBIT-AF study aimed to evaluate the impact of complex weight loss interventions on AF recurrence rate in obese individuals after catheter ablation (CA). METHODS AND RESULTS: The HOBIT-AF was a randomized controlled trial with a 15-month treatment period (3-18 months post CA) involving complex weight-reducing interventions in the active arm. The primary outcome was the change in AF/atrial tachycardia (AT) burden assessed from baseline and the final 14-day Holter monitoring. A total of 167 individuals (aged 59 years, body mass index of 35.6 kg/m2) were randomized into the active (n = 85) and control group (n = 82). At the end of the treatment period, a mean reduction of 6.8 ± 7.0% of the initial body weight accompanied by improvement of metabolic parameters was achieved in the active group. The AF/AT burden change was 0.6 ± 2.5% (95% CI: -4.2-5.5%) in the active group and -0.9 ± 1.8% (95% CI: -4.5-3.0%) in the control group. The AF/AT recurrence-free survival during the 3-18-month follow-up period was comparable between groups (70.4% vs. 69.6%). CONCLUSION: HOBIT-AF trial showed that despite the beneficial effect of body weight reduction on metabolic profile of obese patients with predominantly paroxysmal AF after CA, no reduction in AF/AT recurrence was observed in comparison with control patients. This may be likely due to low AF burden after previous CA, limiting further improvement."}