Heightened Risk of Intensive Rate Control in Patients With Atrial Fibrillation Who Are Obese or Have Type 2 Diabetes: A Critical Review and Re ‐Evaluation

AbstractAtrial fibrillation (AF) is common in patients with obesity and diabetes; the arrhythmia (if long ‐standing) is typically managed by rate‐control and anticoagulation. However, the coexistence of these two metabolic disorders complicates therapeutic options for rate‐control. The likely pathogenesis of AF in these patients is an expansion of epicardial adipose tissue, whose inflammation is t ransmitted to the left atrium causing electromechanical remodeling. However, this same process is also transmitted to the left ventricle, impairing its distensibility and its ability to tolerate volume, leading to heart failure with preserved ejection fraction. Unfortunately, the latter diagnosis (a lthough commonly present in patients with AF and a coexistent metabolic disorder) is often ignored. To achieve rate control, physicians prescribe intensive treatment with atrioventricular (AV)‐nodal blocking drugs, often at doses that are titrated to blunt exercise as well as resting heart rate re sponses. However, strict rate control (target rate
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: COMPREHENSIVE REVIEWS Source Type: research

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Atrial fibrillation (afib) is a common heart rhythm disorder in which the upper chambers of the heart (the atria) beat fast and irregularly. Afib commonly causes recurrent symptoms, usually palpitations and shortness of breath, and can negatively affect quality of life. Afib also substantially increases the risk of stroke, and is also associated with heart failure, high blood pressure, and diabetes. People with afib routinely require lifelong treatment with blood thinners, to prevent blood clots that can lead to strokes. Doctors are only recently understanding the importance of lifestyle factors in treating afib. Modifiabl...
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Fight Aging! publishes news and commentary relevant to the goal of ending all age-related disease, to be achieved by bringing the mechanisms of aging under the control of modern medicine. This weekly newsletter is sent to thousands of interested subscribers. To subscribe or unsubscribe from the newsletter, please visit: https://www.fightaging.org/newsletter/ Longevity Industry Consulting Services Reason, the founder of Fight Aging! and Repair Biotechnologies, offers strategic consulting services to investors, entrepreneurs, and others interested in the longevity industry and its complexities. To find out m...
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