Cardionerds: A Cardiology Podcast

409. Journal Club: The ARREST-AF Trial with Drs. Prashanthan Sanders and Mehak Dhande

Jan 31, 2025

Dr. Prashanthan Sanders, a leader in atrial fibrillation prevention, and Dr. Mehak Dhande, an electrophysiologist focusing on lifestyle changes, discuss the groundbreaking ARREST-AF trial. They reveal how an intensive risk factor management program significantly improved outcomes for atrial fibrillation patients. Topics include successful lifestyle modifications like weight loss and better management of health conditions, along with strategies to enhance patient education and access to care. Their insights emphasize the need for tailored approaches in cardiovascular health.

36:04

Creator website

Episode guests

Mehak Dhande

Prashanthan Sanders

AI Summary

AI Chapters

Episode notes

Podcast summary created with Snipd AI

Quick takeaways

The ARREST-AF trial revealed that an intensive lifestyle risk factor management program significantly improves atrial fibrillation outcomes compared to usual care.

Integrating lifestyle modifications with traditional treatments enhances patient engagement and long-term health, emphasizing the need for comprehensive management strategies.

Deep dives

Zoll LifeVest Innovations and Patient Comfort

Zoll LifeVest has continuously enhanced their wearable defibrillator over the past 20 years, achieving a median wear time of 23.4 hours per day. With the latest garment being lightweight and breathable, it has been favored by patients for improved comfort. Notably, the AI-enhanced algorithm has successfully reduced false alarms to zero at a 90-day mark, exemplifying the commitment to increasing patient safety and experience while monitoring heart conditions. These advancements highlight the significance of comfort and reliability in wearable medical technology, particularly for patients with heart rhythm disorders.

Intro

2min

Managing Atrial Fibrillation: Integrating Lifestyle and Medical Strategies

14min

Integrative Strategies in Atrial Fibrillation Management

14min

Equitable Access to Healthcare: Addressing Systemic Barriers

2min

Simplifying Care Pathways and Building Trust in Cardiology

2min

Navigating Healthcare Costs and Value-Based Care in Atrial Fibrillation Management

3min

The ARREST-AF Trial with Drs. Prashanthan Sanders and Mehak Dhande

Join CardioNerds EP Council Chair Dr. Naima Maqsood and Episode Lead Dr. Jeanne De Lavallaz as they discuss the results of the ARREST-AF Trial with expert faculty Dr. Prashanthan Sanders and Dr. Mehak Dhande. Audio editing by CardioNerds intern Bhavya Shah.

The ARREST-AF trial enrolled 122 patients with a BMI of 27 kg/m²or greater and at least one cardiovascular risk factor with either paroxysmal or persistent AF and were scheduled to undergo de novo AF ablation. They were randomized to an intensive risk factor management (RFM) program versus usual care. The RFM program addressed obesity, sleep apnea, HTN, HLD, tobacco, and alcohol abuse, whereas the usual care arm had a discussion of risk factors but without an extensive risk factor modification or follow-up program. The study population had a mean age of 60 years, a mean BMI of 33 kg/m², and 56-60% of patients with persistent AF. A third of the study population was female. The trial showed a significant improvement in the primary endpoint of the percentage of patients free from atrial fibrillation after ablation in those receiving the intensive lifestyle RFM program. At the end of the 12.3-month follow-up period, 66% percent of patients in the RFM group were free from AF compared to 42% in the usual care group (HR 0.53, p = 0.03). The RFM group also showed significant improvement in AF symptom severity, decline in body weight, systolic blood pressure, glycemic control, and exercise capacity. On average, patients in the RFM arm lost 9 kg of weight compared to 1 kg in the control group. Similarly, systolic blood pressure decreased by 13.1 mmHg in the RFM group but increased by four mmHg in the control group.

This episode was planned in collaboration with Heart Rhythm TV with mentorship from Dr. Daniel Alyesh and Dr. Mehak Dhande.

Enjoy this Circulation 2022 Paths to Discovery article to learn about the CardioNerds story, mission, and values.

US Cardiology Review is now the official journal of CardioNerds! Submit your manuscript here.

CardioNerds Journal Club Page
CardioNerds Episode Page
CardioNerds Academy
Cardionerds Healy Honor Roll

CardioNerds Journal Club
Subscribe to The Heartbeat Newsletter!
Check out CardioNerds SWAG!
Become a CardioNerds Patron!