Sustaining sinus rhythm after atrial fibrillation (AF) ablation remains a key clinical challenge. A multicenter randomized trial published in JAMA Cardiology found that structured lifestyle and risk factor management (LRFM) substantially improved rhythm stability and cardiometabolic outcomes in adults with elevated body mass index (BMI ≥ 27) and additional metabolic risk factors.

The study enrolled 122 patients (mean age 60 years; 67% male) undergoing first-time AF ablation across three centers. Participants were randomized to intensive LRFM or usual care. After 12 months, 61% of the LRFM group maintained sinus rhythm compared with 40% of controls (P = .03). The risk of arrhythmia recurrence was nearly halved (hazard ratio 0.53; 95% CI 0.32–0.89).

Patients receiving LRFM achieved a mean 9 kg weight loss, 7 cm waist reduction, and a 10.8 mm Hg decrease in systolic blood pressure. AF symptom scores improved significantly compared with standard care.
These findings highlight the value of structured lifestyle and risk factor management in improving rhythm stability and cardiovascular outcomes after AF ablation.