JACC in a Flash | Incremental increases in body mass index (BMI) are significantly associated with an increased risk of incident, post-operative, and post-ablation atrial fibrillation (AF), according to a new study published May 27 in JACC: Clinical Electrophysiology.

Researchers examined data from a total of 51 studies including 626,603 participants. Studies were included if they were cross-sectional, case-control, or cohort studies that allowed for the assessment of associations between BMI and incident AF, post-operative AF, or post-ablation AF. For every five unit increase in BMI, there was a 19% to 29% greater risk of developing AF, a 10% greater excess risk of post-operative AF, and a 13% greater excess risk of recurrent AF post-ablation.

It is estimated that there are 33 million people living with AF worldwide. The annual incremental cost of AF is estimated at $26 billion in the United States, with hospitalizations—a major factor in cost—increasing faster than other cardiovascular conditions. As the population ages, this increase will further accelerate. The authors argue that a greater focus and effort is necessary to reduce the risk factors for AF in order to prevent its development and burden. Obesity is one of these risk factors, and may account for 60% of AF cases, as it is a modifiable risk factor that should be targeted to reduce the development of AF.

“The results of this study show that even moderate reductions in population BMI potentially could significantly reduce the burden of AF,” said Craig T. January, MD, PhD, writing committee chair of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial. “A decrease in obesity would also lower rates of conditions such as diabetes and hypertension, which are also risk factors for AF and would therefore have a greater impact on reducing this condition.”

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References

1. Wong CX, Sullivan T, Sun MT, et al. JACCCEP. 2015;doi:10.1016/j.jacep.2015.04.004.

Keywords: CardioSource WorldNews, ACC Publications, Atrial Fibrillation, Body Mass Index

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