Background Risk factors of atrial fibrillation include diabetes, obesity and physical inactivity. Positive effects such as decreased atrial fibrillation burden have been reported for atrial fibrillation patients who have participated in lifestyle changing interventions after atrial fibrillation ablation treatment. Aim The aim of this study was to assess the evidence on the benefits and harms of lifestyle and risk factor management interventions in patients undergoing atrial fibrillation ablation. Method Our systematic review searched MEDLINE, EMBASE, CINAHL, Psychinfo, Web of Science and CENTRAL using key terms related to atrial fibrillation and lifestyle, including interventional trials. The primary outcomes were mortality and serious adverse events. Random effects meta-analyses of outcomes were conducted when appropriate. Results Two randomised controlled trials and two non-randomised interventional trials with a total of 498 patients were included. Six primary events were reported for the intervention groups and five events for the control groups (relative risk of 1.03, 95% confidence interval (CI) 0.3 to 3.1, I2 0%, P = 0.537). Effects in favour of the intervention groups were found for atrial fibrillation frequency (0.82 points, 95% CI –1.60 to –0.03, I2 87.3%, P = 0.005), atrial fibrillation duration (–0.76 points, 95% CI –1.64 to 0.12, I2 89.1%, P = 0.002) and body mass index (–5.40 kg/m2, 95% CI 6.22 to –2.57, I2 83.9%, P = 0.013). Risk of bias in the four studies was judged to be low to moderate. Conclusion Lifestyle changing interventions seem to have a positive effect on outcomes relevant to patients undergoing atrial fibrillation ablation, but the included studies were small, interventions were inhomogeneous, and the quality of evidence was low to moderate. More studies are warranted.

中文翻译：

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房颤消融后的生活方式干预：系统评价

背景 房颤的危险因素包括糖尿病、肥胖和缺乏运动。对于房颤消融治疗后参与生活方式改变干预的心房颤动患者，已经报道了降低心房颤动负担等积极作用。目的 本研究的目的是评估生活方式和风险因素管理干预对房颤消融患者的益处和危害的证据。方法 我们的系统评价使用与心房颤动和生活方式相关的关键术语（包括介入试验）搜索了 MEDLINE、EMBASE、CINAHL、Psychinfo、Web of Science 和 CENTRAL。主要结局是死亡率和严重不良事件。适当时对结果进行随机效应荟萃分析。结果 共纳入 498 名患者的两项随机对照试验和两项非随机干预试验。干预组报告了 6 个主要事件，对照组报告了 5 个事件（相对风险为 1.03，95% 置信区间 (CI) 0.3 至 3.1，I2 0%，P = 0.537）。在房颤频率（0.82 点，95% CI –1.60 至 –0.03，I2 87.3%，P = 0.005）、房颤持续时间（–0.76 点，95% CI –1.64 至 0.12）方面发现有利于干预组的效果, I2 89.1%, P = 0.002) 和体重指数 (–5.40 kg/m2, 95% CI 6.22 to –2.57, I2 83.9%, P = 0.013)。四项研究的偏倚风险被判断为低到中等。结论 改变生活方式的干预措施似乎对接受房颤消融的患者的结局产生积极影响，但纳入的研究规模较小，干预措施不均匀，证据质量为低至中等。有必要进行更多的研究。