Improving Outcomes After AF Ablation in Obese Patients (OBESE-AF)

May 24, 2026 updated by: National Taiwan University Hospital

Outcome Improvement in Obese Patients With Atrial Fibrillation After Catheter Ablation: Importance of Gut Microbiota Dysbiosis and Adipose Tissue Biology

Improving Outcomes After AF Ablation in Obese Patients

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Detailed Description

This is a prospective randomized clinical study designed to evaluate the roles of gut microbiota dysbiosis, adipose tissue biology, and post-ablation lifestyle intervention in patients with atrial fibrillation undergoing catheter ablation. Patients with paroxysmal or persistent atrial fibrillation who are scheduled to undergo catheter ablation at National Taiwan University Hospital will be enrolled after informed consent.

All participants will undergo standard-of-care catheter ablation and receive guideline-directed management for atrial fibrillation, including treatment of cardiovascular conditions, anticoagulation, and rate or rhythm control as clinically indicated. After the index ablation procedure, participants will be randomly assigned in a 1:1 ratio to either an intensive lifestyle modification program or usual care.

Participants assigned to the intensive lifestyle modification group will receive dietary counseling for weight reduction when indicated and an exercise-based cardiac rehabilitation program. The rehabilitation program will include supervised aerobic exercise and resistance or strength training, together with recommendations for home-based moderate-intensity walking exercise. Participants assigned to the usual care group will continue their usual lifestyle and receive standard post-ablation clinical follow-up.

The study will collect clinical characteristics, procedural data, rhythm follow-up data, biological samples, and imaging-based measurements. Gut microbiota dysbiosis will be assessed using stool specimens and high-throughput sequencing of the V3 and V4 hypervariable regions of 16S rRNA. Adipose tissue biology will be evaluated using computed tomography to quantify the amount and distribution of adipose tissue, including epicardial, paracardial, pericardial, visceral, and subcutaneous fat. Serum biomarkers related to inflammation and fibrosis, including hs-CRP, TNF-alpha, IL-1 beta, ST2, and galectin-3, will also be assessed.

Cardiac structural remodeling will be evaluated using cardiac computed tomography and echocardiography, including left atrial size, left ventricular mass, left ventricular ejection fraction, and parameters of left ventricular diastolic function. Electrophysiological remodeling of the left atrium will be assessed using three-dimensional voltage mapping during the ablation procedure, including the extent of scar and low-voltage zones.

Participants will undergo rhythm follow-up after catheter ablation using 12-lead electrocardiography, continuous patch electrocardiographic monitoring, and Holter monitoring as clinically indicated. The study will evaluate AF-free survival after the blanking period and will explore whether the post-ablation lifestyle intervention modifies ablation outcomes, body mass index, metabolic parameters, gut microbiota dysbiosis, adipose tissue biology, cardiac structural remodeling, and electrophysiological remodeling.

Study Type

Interventional

Enrollment (Estimated)

520

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

  • Name: Yen Bin, Liu Associate Professor of Medicine, MD, PhD
  • Phone Number: +886-0972651035
  • Email: yenbin@ntu.edu.tw

Study Contact Backup

  • Name: Chun Kai, Chen Visiting staff, MD
  • Phone Number: +886-0921915778
  • Email: neochen@ntuh.gov.tw

Study Locations

  • Taiwan
      • Taipei, Taiwan
        • Recruiting
        • National Taiwan University Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Patients with Class I indication of catheter ablation of paroxysmal or persistent AF and will undergo catheter ablation at National Taiwan University Hospital.

Exclusion Criteria:

  1. Informed consent could not be obtained due to personal problem
  2. Unwillingness or inability to return for follow-up visits or reason to believe that adherence to follow-up visits wound be irregular
  3. Current or scheduled enrollment in other conflicting studies, and
  4. Concomitant disease or other medical condition likely to result in death within 6 months

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Cardiac rehabilitation
Participants assigned to this arm will receive an intensive lifestyle modification program after the index catheter ablation procedure. The program includes an exercise-based cardiac rehabilitation program with aerobic exercise and resistance or strength training, in addition to standard post-ablation care.
Behavioral: Cardiac Rehabilitation and Lifestyle Modification
The intervention consists an exercise-based cardiac rehabilitation program after catheter ablation. The rehabilitation program includes supervised aerobic exercise and resistance or strength training, together with recommendations for home-based moderate-intensity walking exercise.
Active Comparator: Usual Care
Participants assigned to this arm will continue their usual lifestyle and receive standard post-ablation clinical follow-up after the index catheter ablation procedure.
Behavioral: Usual Care
Participants assigned to this arm will continue their usual lifestyle and receive standard post-ablation clinical follow-up after the index catheter ablation procedure.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Atrial Fibrillation-Free Survival After Catheter Ablation
Time Frame: From 3 months after catheter ablation through study follow-up, up to 36 months
Atrial fibrillation-free survival after the 3-month blanking period following the index catheter ablation procedure. Rhythm status will be assessed using 12-lead electrocardiography, 7-day continuous patch electrocardiographic monitoring at 6 months, and annual 24-hour Holter monitoring after the index ablation procedure.
From 3 months after catheter ablation through study follow-up, up to 36 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

National Taiwan University Hospital

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 16, 2021

Primary Completion (Estimated)

May 1, 2030

Study Completion (Estimated)

May 1, 2030

Study Registration Dates

First Submitted

May 24, 2026

First Submitted That Met QC Criteria

May 24, 2026

First Posted (Actual)

June 1, 2026

Study Record Updates

Last Update Posted (Actual)

June 1, 2026

Last Update Submitted That Met QC Criteria

May 24, 2026

Last Verified

May 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 202006062RINC

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

UNDECIDED

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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