Sanghamitra Mohanty, MD, FHRS, Chintan Trivedi, MD, MPH, FHRS, Domenico Giovanni Della Rocca, MD, Carola Gianni, MD, Bryan MacDonald, MD, Angel Mayedo, MD, SaiShishir Shetty, DPharm, MHI, Eleanora Natale, HSGrad, John D. Burkhardt, MD, FHRS, Mohamed Bassiouny, MD, G. Joseph Gallinghouse, MD, Rodney Horton, MD, Amin Al-Ahmad, MD, FHRS, and Andrea Natale, MD, FACC, FHRS, FESC
Introduction: Obesity, a known risk factor for atrial fibrillation (AF), is potentially reversible through lifestyle changes, including diet and physical activity. However, lack of compliance is a major obstacle in attaining sustained weight loss. We investigated the impact of patient engagement using a digital monitoring system on compliance for lifestyle-change measures and subsequent outcome. Methods: A total of 105 consecutive patients with coexistent AF and obesity (body mass index ≥28) were classified into 2 groups based on the monitoring method: group 1, use of digital platform (n = 20); group 2, conventional method (n = 85). Group 1 used the RFMx digital monitoring platform (smartphone app) that sets weekly goals for exercise and weight loss, tracks patient compliance data continuously, and sends regular text reminders. Conventional method included monitoring patients’ adherence to diet and change in weight during in-person clinic visits or monthly phone calls from staff. Results: Baseline characteristics of groups 1 and 2 were comparable. At 6 months of follow-up, 12 (60%) and 28 (33%) from group 1 and 2, respectively, were compliant with the physician instructions regarding diet and exercise (P = .025). Weight loss was observed in 9 of 12 (75%) from group 1 and 11 of 28 (39%) from group 2 (P = .038) and mean reduction in weight was 9.9 ± 8.9 lb and 4.0 ± 2.1 lb (P = .042). Conclusion: In this series, continuous digital monitoring was seen to be associated with significant improvement in compliance through better patient engagement, resulting in more weight loss compared to the conventional method.