P348Motivation of overweight patients with atrial fibrillation to lose weight or to follow a weight loss management program: a cross-sectional study
Authors: Delesie M , Desteghe L , Bertels M , Gerets N , Van Belleghem F , Meyvis J , Elegeert I , Dendale P , Heidbuchel H 
Published: June 2020

Abstract

Funding Acknowledgements
none

Background
Overweight and obesity increase the risk of recurrence and progression of atrial fibrillation (AF). Studies evaluating weight reduction programs in AF patients have shown benefits in AF burden, symptoms and quality of life. Despite this proof, AF patients often lack the will to tackle overweight and they do not commonly participate in cardiac rehabilitation programs.

Purpose
The objective of this study was to assess the motivation of AF patients with overweight or obesity to lose weight and/or to follow weight reduction programs.

Methods
A multicenter descriptive cross-sectional study was performed at three Belgian hospitals. A self-developed questionnaire was presented to AF patients with a BMI &gt;27kg/m2 who presented for an outpatient cardiology visit or were hospitalized at the cardiology ward. The questionnaire was validated for its content by an expert panel and it addressed the following topics: knowledge about the relation between weight and AF; patients’ history of weight reduction efforts and its success; current motivation to reduce weight; factors related to motivation; interest in following weight reduction programs.

Results
A total of 143 patients (mean age 65.7 ± 9.2 years; mean BMI 32.3 ± 4.7kg/m2; 68.5% males; 47.6% hospitalized; mean duration of AF history 5.7 ± 6.0 years) out of 560 screened AF patients completed the questionnaire (figure 1).
Only 69.9% of patients was aware of the positive effect of weight reduction on the progression of AF.
Prior attempts to reduce weight were made by 76.2% of the patients in which a minority participated in a hospital-based weight reduction program (9.2%) or a structured fitness program (10.1%).
Of the study patients, 75.5% were currently motivated to reduce weight, mainly driven by health considerations (78.7%). Univariate analysis showed that a higher educational degree, higher income, living with a partner, and higher BMI were positively correlated with motivation to reduce weight (p &lt; 0.05). Multivariate regression analysis showed that a higher BMI (OR = 1.20; CI = 1.05-1.38; p = 0.010), younger age (0.96 (0.91-1.01); p = 0.108), a college/university degree (5.03 (1.57-16.16); p = 0.007) and living with a partner (4.31 (1.55-11.95); p = 0.005) were associated with greater odds ratio of motivation for weight reduction.
A completely home-based program (including tele-rehabilitation) was the preferred approach for 57.9% of the patients, and 57.3% would consider a weight reduction program only if reimbursement was available.

Conclusions
AF patients with overweight still need to be better informed about overweight as a risk factor for AF. AF patients with a lower degree of education, living alone and a lower BMI need more external motivation to lose weight. A tailored weight reduction program, mainly home based, is the preferred option for patients. This will require further development and validation of tele-coaching programs for this patient group.
Abstract Figure 1: Enrollment procedure