Obesity and Atrial Fibrillation | Journal Scan

Study Questions:

What is the contribution of obesity in the incidence of atrial fibrillation (AF) in various settings?

Methods:

Published studies that reported the incidence of AF, including after cardiac surgery and catheter ablation, were included. Odds ratios per unit of body mass index (BMI) were abstracted or calculated.

Results:

Among a candidate of 399 studies, 51 studies were included in the meta-analysis. From analysis of cohort (n = 9; 157,518 individuals, and 6,088 cases of AF) and case-control studies (n = 14; 401,061 individuals, and 65,546 cases), there was a 29% and 19% excess risk of developing AF for every 5-unit increase in BMI, respectively. There was a 10% greater risk of developing postoperative AF (9 studies; 62,160 individuals, and 16,768 cases) for every 5-unit increase in BMI. Similarly, there was a 13% excess risk of post-ablation AF (16 studies; 5,864 patients) for every 5-unit increase in BMI.

Conclusions:

The authors concluded that an increase in BMI is associated with an excess risk of AF in a variety of settings.

Perspective:

Obesity is associated with structural and electrical atrial remodeling that is thought to promote AF. This study adds to a large body of evidence supporting the association between obesity and AF. The authors conjecture that even moderate reductions in BMI, as they have shown in a prior study, may have a favorable effect in not only reducing arrhythmia burden (secondary prevention), but also preventing AF (primary prevention).

Clinical Topics: Arrhythmias and Clinical EP, Cardiac Surgery, Invasive Cardiovascular Angiography and Intervention, Prevention, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Cardiac Surgery and Arrhythmias

Keywords: Arrhythmias, Cardiac, Atrial Fibrillation, Atrial Remodeling, Body Mass Index, Cardiac Surgical Procedures, Case-Control Studies, Catheter Ablation, Heart Conduction System, Incidence, Obesity, Primary Prevention, Risk, Secondary Prevention


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