PREDIMAR Trial: Mediterranean Diet with Olive Oil Reduces Tachyarrhythmia Recurrence After Atrial Fibrillation Ablation

The study found that among atrial fibrillation patients who had ablation, those assigned to a Mediterranean diet enriched with extra-virgin olive oil were less likely to have arrhythmia recurrence versus those with no dietary restrictions.

According to findings from the trial presented at Heart Rhythm 2024, the difference was most pronounced for patients with paroxysmal AF at baseline.

Atrial fibrillation, the most common form of arrhythmia, affects millions worldwide and poses significant challenges due to its association with increased risk of stroke, heart failure, and other cardiovascular complications. Catheter ablation has emerged as a cornerstone in AF management, but recurrence of tachyarrhythmia post-ablation remains a concern, necessitating novel approaches to optimize long-term outcomes.

Strategies for improving results for AF ablation have focused on pharmacology and technology but have not extensively looked at lifestyle and diet. The PREDIMAR study sought to determine whether a Mediterranean diet enriched with extra-virgin olive oil could be integrated into treatment plans for paroxysmal AF patients undergoing catheter ablation to reduce their risk of tachyarrhythmias recurrence.

The trial, led by researchers at the University of Navarra, University Hospital HM Monteprincipe, Virgen de las Nieves Hospital, and General Hospital of Alicante in Spain, included 720 AF patients treated with ablation. They were randomized in a 1:1 ratio; one group received advice to follow a Mediterranean diet enriched with extra-virgin olive oil or their freely selected diet.

The trial followed all patients for 18 months, with medical visits every 3 to 6 months. They also received an electrocardiogram recording device to use once a week and if they had any symptoms.

The researchers reported the following findings:

· After 18 months, the results showed a 10% relative reduction in the risk of tachyarrhythmia recurrence in patients following the Mediterranean diet enriched with extra-virgin olive oil compared to patients who freely selected their diet. This reduction was even higher in patients with paroxysmal AF at baseline (before ablation).

· These patients experienced a 31% relative reduction in the risk of recurrence with the Mediterranean diet intervention compared to the freely selected diet.

"Patients frequently ask me about what diet and lifestyle changes are most impactful after being diagnosed with atrial fibrillation or following an ablation," said Maria Teresa Barrio Lopez, M.D., PhD, Cardiologist, University Hospital HM Monteprincipe in Spain.

"Seeing the results of the PREDIMAR trial, I feel confident in recommending the Mediterranean diet enriched with extra-virgin olive oil to patients to help reduce the risk of recurrences."

The implementation of a dietetic program for patients holds the potential to not only lower arrhythmia recurrence but also impact hospital and emergency admissions, the risk of stroke associated with AF, and additional ablation procedures.

Reference:

"Late Breaking Clinical Trials: Mediterranean diet enriched with extra-virgin olive oil reduced risk of tachyarrhythmia recurrence after atrial fibrillation ablation: the PREDIMAR trial [Saturday, May 18, 2024, at 2:00 pm ET]