{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T04:04:31Z","timestamp":1792728271789,"version":"4.5.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T00:00:00Z","timestamp":1756512000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001826","name":"Netherlands Organisation for Health Research and Development","doi-asserted-by":"publisher","award":["10070012010001"],"award-info":[{"award-number":["10070012010001"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>Atrial fibrillation (AF) is associated with various lifestyle risk factors. Their presence negatively affects AF catheter ablation outcomes. This study evaluates the efficacy of a nurse-led, integrated lifestyle programme on ablation outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>POP-AF is a prospective, randomized, controlled trial involving patients referred for their first AF ablation. 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). 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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. The median age of patients was 62 years, 26% were women, and 59% had persistent AF. Median ILT duration was 5 months. 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 [incidence relative risk (RR) 0.49, 95% confidence interval (CI) 0.30\u20130.78, P = .004]. The rates of repeat ablations (RR 0.43, 95% CI 0.18\u20130.94, P = .045) and direct current cardioversions (RR 0.52, 95% CI 0.28\u20130.92, P = .031) were also lower in the ILT group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Integrated lifestyle modification before catheter ablation reduces both repeat ablations and direct current cardioversions by half until 12 months after index ablation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehaf689","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T11:52:13Z","timestamp":1755690733000},"page":"669-679","source":"Crossref","is-referenced-by-count":24,"title":["Improving outcomes of atrial fibrillation ablation by integrated personalized lifestyle interventions: a randomized controlled 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