Surgical Weight Loss to Treat Atrial Fibrillation Risk and Progression

AbstractPurpose of ReviewThis review aims to examine the breadth of data associating atrial fibrillation (AF) with obesity at epidemiologic, mechanistic, and clinical levels. We then proceed to place surgical weight loss within that context.Recent FindingsEpidemiologic studies have demonstrated a robust correlation between overweight and AF. Various mechanistic factors including concomitant risk factors, diastolic impairment, inflammation, and pericardial fat have been observed to contribute to the atrial substrate for AF. However, weight loss can institute a process of reverse atrial remodeling improving arrhythmias profile. Thus, weight loss has emerged as an indispensable aspect of effective AF management. Yet, effective weight management is often a challenging and frustrating journey for clinician and patient, raising surgical weight loss as a potential option. However, data on the role of surgical weight loss on AF are limited. Observations indicate that the dramatic and sustained weight loss availed by surgical intervention may be capable of attenuating rates of incident AF. The impact of surgical weight loss on AF populations remains unknown. However, it is likely that most of the antiarrhythmic benefits of non-surgical weight loss would be paralleled in surgical candidates, mediated by similar mechanisms. Surgical weight loss has been associated with reverse structural remodeling, improvement of diastolic function, and modulation of the autonomic profile.SummaryThere ...
Source: Current Cardiovascular Risk Reports - Category: Cardiology Source Type: research