Impact of Risk‑Factor Modification on Atrial Fibrillation Recurrence: A Meta‑Analysis

Abstract 2294798, presented at Western Atrial Fibrillation Symposium 2026

Obesity, hypertension, obstructive sleep apnea (OSA) and alcohol intake contribute to atrial fibrillation (AF) onset and recurrence. The effectiveness of structured risk‑factor modification programs following ablation or medical therapy remains uncertain.Randomized and observational studies (January 2000–July 2025) assessing lifestyle interventions such as weight reduction, structured exercise, OSA treatment or alcohol abstinence on AF recurrence were identified through MEDLINE, EMBASE and Cochrane databases. Hazard ratios (HRs) were pooled using random‑effects models.Fifteen studies comprising 6,900 patients were included. Comprehensive risk‑factor management programs combining weight loss, exercise and OSA therapy reduced AF recurrence by 33% (HR 0.67, 95% CI 0.55–0.80). Weight reduction ≥10% yielded a 23% relative risk reduction; continuous positive airway pressure in moderate‑to‑severe OSA reduced recurrence by 21%. Alcohol abstinence resulted in a 14% reduction. Benefits were consistent across paroxysmal and persistent AF, with moderate heterogeneity (I² = 36%).Integrated management of modifiable risk factors substantially reduces AF recurrence, supporting guideline recommendations for comprehensive lifestyle interventions. Adherence strategies are essential for sustained benefit.