Background and rationale
obesity, diabetes mellitus, OSA, atrial fibrillation
OBESITY, RECURRENCE, ATRIAL FIBRILLATION (AF), DIABETES MELLITUS, SLEEP APNOEA, ATRIAL FIBRILLATION, HYPERTENSION
The management of atrial fibrillation (AF) is complex and many patients experience recurrence of symptoms after an invasive treatment with catheter ablation [Several lifestyle risk factors have previously been identified as promoters of AF. These risk factors include obesity, physical inactivity, sleep apnoea, hypertension, smoking, alcohol use and diabetes mellitus [The observational ARREST-AF and LEGACY trials clearly demonstrate beneficial effects on ablation outcomes when the management of different risk factors is combined [The AHA 2020 scientific statement and ESC/EHRA 2020 guidelines for atrial fibrillation include recommendations on lifestyle focussed treatment as part of the management of AF [Integrated care reduces morbidity and mortality of AF patients if care is provided by well-trained nurses, because adherence to guidelines is stricter and patient education is more personalized [The goal of the POP trial is to ascertain whether in subjects with a high burden of AF and at least one treatable lifestyle risk factor, implementation of an integral AF clinic, focusing on lifestyle improvement, OSA screening, and on patient education, is beneficial for ablation outcomes. This trial aims to provide more certainty to the current limited evidence regarding the implementation of personalized integrated treatment in current AF care.