Mediterranean Diet Coupled with Extra-Virgin Olive Oil Reduces Risk of Atrial Fibrillation Recurrence Post-Ablation

BOSTON, MA, May 18, 2024 – A new clinical trial found that patients with previous paroxysmal atrial fibrillation (AF) who follow a Mediterranean diet enriched with extra-virgin olive oil after a catheter ablation procedure saw improved clinical outcomes when compared to those who freely selected their diet. The PREDIMAR study, led by researchers at the University of Navarra, University Hospital HM Monteprincipe, Virgen de las Nieves Hospital and General Hospital of Alicante in Spain, is one of the few trials to evaluate the effects of a specific diet on patients with AF after ablation to reduce the risk of recurrence. Findings were presented today as a late-breaking clinical trial during Heart Rhythm 2024.

AF is the most common sustained cardiac arrhythmiaⁱ. It is associated with considerable morbidity and mortality caused by related heart failure and ischemic stroke.^ii,iii Global estimates of AF prevalence vary widely, ranging from approximately 1% to 2% in the U.S.^iv With an older population in Spain, the prevalence is higher, reaching up to 4.4%.^iv

Catheter ablation is a common AF treatment option. Strategies for improving results for AF ablation have focused on technology and pharmacology 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.

In the trial, researchers randomized 720 AF patients treated with ablation in a 1:1 ratio, with one group receiving 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. Additionally, they received an electrocardiogram recording device to use once a week and if they had any symptoms.

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 has the potential to not only reduce arrhythmia recurrence, but also influence hospital and emergency admissions, additional ablation procedures, and the risk of stroke associated with AF.

Session Details

"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]

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^v Gómez-Doblas JJ, Muñiz J, Martin JJ, Rodríguez-Roca G, Lobos JM, Awamleh P, Permanyer-Miralda G, Chorro FJ, Anguita M, Roig E; OFRECE study collaborators. Prevalence of atrial fibrillation in Spain. OFRECE study results. Rev Esp Cardiol (Engl Ed). 2014 Apr;67(4):259-69. doi: 10.1016/j.rec.2013.07.014. Epub 2013 Nov 25. PMID: 24774588.

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