Arrhythmias and conduction disturbanceRelation of Obesity to Recurrence Rate and Burden of Atrial Fibrillation
Section snippets
Methods
To evaluate the relation of obesity with recurrence of AF or burden of AF, we used a limited access data set from the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) trial, provided by the National Heart, Lung, and Blood Institute (Bethesda, Maryland). Detailed selection criteria for the study population, their baseline characteristics, and randomization into rate-control versus rhythm-control arms was previously explained.6
Our main independent variable was BMI. We
Results
In the AFFIRM study, 4,060 patients were enrolled at baseline. We excluded 1,542 patients who did not have baseline BMI information. Of the remaining 2,518 patients, 1,255 were assigned to the rate-control arm and 1,263 to the rhythm-control arm; the mean BMIs were 29.0 and 28.8 kg/m2, respectively. These 2,518 patients had 22,753 follow-up visits and a total of 1,094 cardioversions, either pharmacologic or electrical: 888 in the rhythm-control arm and 206 in the rate-control arm.
In a
Discussion
In this analysis of a limited-access data set from the AFFIRM trial, we have demonstrated for the first time that obesity is associated with a higher recurrence rate and greater burden of AF compared to nonobese patients. Because in the rate-control arm, the strategy was not to restore sinus rhythm, patients spent more time in AF than patients in the rhythm-control arm. The difference between AF burden in obese versus nonobese patients was significant in the rate-control arm as well as in the
References (12)
- et al.
Overweight and obesity as risk factors for atrial fibrillation or flutter: the Danish Diet, Cancer, and Health Study
Am J Med
(2005) - et al.
The long- and short-term impact of elevated body mass index on the risk of new atrial fibrillation: the WHS (Women's Health Study)
J Am Coll Cardiol
(2010) - et al.
Atrial fibrillation and obesity—results of a meta-analysis
Am Heart J
(2008) - et al.
Predictors of paroxysmal atrial fibrillation in patients undergoing aortic valve replacement
J Thorac Cardiovasc Surg
(2007) - et al.
The aging process of the heart: obesity is the main risk factor for left atrial enlargement during aging the MONICA/KORA (Monitoring of Trends and Determinations in Cardiovascular Disease/Cooperative Research in the Region of Augsburg) study
J Am Coll Cardiol
(2009) - et al.
Obesity and outcomes among patients with established atrial fibrillation
Am J Cardiol
(2010)
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2020, Nutrition, Metabolism and Cardiovascular DiseasesCitation Excerpt :The mechanisms of obesity paradox have not been fully elucidated yet and there might be several explanations for this phenomenon in patients with AF. Firstly, it has been acknowledged that obesity is associated with heavier AF burdens, which could lead to timely diagnosis and treatment [6]. On the other hand, patients with atrial fibrillation are often accompanied by a high rate of comorbidities, such as hypertension, DM, hyperlipemia, coronary artery disease and heart failure [1,2].
Impact of Lifestyle Modification on Atrial Fibrillation
2020, American Journal of CardiologyCitation Excerpt :Notably, the relationship between BMI and AF persisted after controlling for other risk factors including cardiovascular disease, hypertension, and diabetes.5 Obesity is not only associated with a greater risk of new-onset AF, but it is also associated with a greater burden of recurrent and permanent AF.5-8 Tsang and colleagues performed a retrospective analysis demonstrating a dose-response relationship between BMI and progression from paroxysmal to permanent AF.