The Link Between Atrial Fibrillation and Obesity
Journal Title: Archives of Diabetes & Obesity - Year 2019, Vol 2, Issue 1
Abstract
The obese population is currently increasing. Atrial fibrillation (AF) is the most common supraventricular arrhythmia. There is a close link between these two pathologies that we will detail in this article. The World Health Organization estimates that cases of obesity have tripled since 1975 with 39% of overweight adults and 13% of obese adults in 2016. Obesity is an independent risk factor of AF and those in spite of other associated comorbidity (sleep apnea, arterial hypertension, physical inactivity, diabetes mellitus ...) [1-4] The increase in the body mass index (BMI) is associated with an increase in the incidence of AF. Conversely, the standardization of BMI is associated with a decrease in the incidence of AF. [2] It is estimated that one in five of AF may be due to being overweight or obesity [5]. Structural remodeling (atrial enlargement, increased fat depots, interstitial fibrosis, increased of left ventricular geometric abnormalities, altered hemodynamics) is a major factor by which obesity promotes AF. [6] Associated with oxidative stress, these two mechanisms are the main cause of AF in the obese patient. We will not discuss the particular pathophysiology of diabetes that is often associated with obesity in this population. Atrial electrical remodeling is a cause and consequence of AF. At the tissue level, electrical remodeling comprises effective refractory period shortening, conduction velocity slowing, wavelength reduction, and frequent atrial ectopic caused by calcium (Ca2+)-dependent triggered activity [7,8]. While Ca2+- mediated triggers serve as the critical initiators of AF, an appropriate substrate formed through progressive electrical and structural remodeling of the atria is required for the long-term perpetuation of the arrhythmia and its conversion from paroxysmal to chronic forms.
Authors and Affiliations
Socié P, Gorka H
Keywords
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- EP ID EP589333
- DOI 10.32474/ADO.2019.02.000127
- Views 37
- Downloads 0
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