Endocrine Abstracts

Introduction: Obesity represents a major public health challenge and is linked with increased risk of multiple medical conditions including atrial fibrillation (AF). We have recently published the study protocol of the ‘The Effect of complex weigHt-reducing interventiOns on rhythm control in oBese subjects wITh Atrial Fibrillation’ (HOBIT-AF) trial. Here we communicate the preliminary results with the focus on the use of smart technologies and telemedicine.

Methods: HOBIT-AF is a single-blinded, parallel-group, randomised controlled trial with 18-month follow-up to assess the effect of complex weight-reducing interventions supported by the use of smart technologies on the arrhythmia burden in obese individuals following catheter ablation for AF. Participants are randomised in a 1:1 fashion to undergo a structured weight reduction programme and optional sleeve gastrectomy aiming to achieve greater than 10% weight reduction (intervention group) or standard post-ablation medical care (control group). All participants are provided with the Apple Watch Series 5 and iPhone (Apple Inc, Cuppertino, CA, USA). Daily initial settings for the intervention group are as follows: 5000 steps, 30 minutes of physical activity, energy expenditure of 300 kCal, home self-monitoring of blood pressure, heart rhythm, body weight, waist circumference etc. Control group have no goals set and use smart technologies solely for the heart rhythm monitoring. Individual patient goals and settings are monitored by healthcare team by a custom made software IKEMOnlineFit.

Results: Thus far 75 patients have been enrolled into the trial of which 50 are male. Mean baseline characteristics are as follows: age 56 years, weight 118 kg, BMI 37 kg/m2, waist circumference 128 cm. 69 % patients suffer from paroxysmal AF, the rest of persistent. No statistically significant differences in baseline characteristics were detected between the groups at randomization time. Thus far, participants in the intervention group lost 6 % in weight, walked on average 8300 steps per day, performs 32 active minutes daily, energy expenditure of 900 kCal daily. Control group have lost 0,4% in weight so far, walked 3700 steps per day, and had energy expenditure of 600 kCal daily. In intervention group,1 patient underwent sleeve gastrectomy, the rest cut down on weight by life-style intervention or were provided by a GLP-1 receptor analogue liraglutide from the 9^thstudy month onwards. All participants use smart technologies.

Conclusion: This time calls for wider usage of smart technologies and telemedicine. Our preliminary results are very promising in relation to their usage in the management of obesity.