Abstract
Obesity and obesity-related illnesses (ORIs) constitute a significant burden on the healthcare system, with a very high prevalence in the general population. Atrial fibrillation (AF) is the most common arrhythmia seen by healthcare providers. The risk of AF in obese individuals is reported to be high and in correlation with Body Mass Index (BMI), leading to the high prevalence of AF in the general population and the expected epidemic of AF to come. Greater left atrial dimensions and left atrial remodeling together form the AF substrate in the obese population along with the role of epicardial adipose tissue (EAT) in inducing inflammation and fibrosis of the atrial myocardium and thus facilitating the onset of AF. In our paper, we reviewed the literature published on the link between obesity and AF, as well as the potential behind new management approaches. Multiple studies have explored different approaches, either conventional or novel. Considering the impact of prevention in medicine nowadays, we proposed a screening practice for AF in obese individuals. More research is needed to acquire a comprehensive protocol for the management of AF in the obese population that can be applied by primary healthcare providers to combat this evolving matter.
Highlights
BackgroundObesity is unceasingly on the rise worldwide, accompanied by obesity-related illnesses (ORIs)
This was revealed by a recent study in 2018 that found a significant association between obesity and volumes of epicardial adipose tissue (EAT) and demonstrated by scanning for areas of low voltage, slow conduction, and voltage heterogeneity, that such changes are more pronounced in areas closer to EAT denoting the role of EAT in provoking Atrial fibrillation (AF) [26], which in turn brings us to the point of electrical remodeling
The results showed a correlation between the interatrial electromechanical delay and highly sensitive C-reactive protein (CRP) levels, which is known to be associated with the presence of heart diseases [29]
Summary
Obesity is unceasingly on the rise worldwide, accompanied by obesity-related illnesses (ORIs). One study found that obesity represents a novel risk factor for AF associated with an increase in the incidence of 50% [5]. Certain characteristics will be discussed concerning this population: a) incidence and prevalence of AF; b) pathophysiological aspects; c) potential approaches to management and treatment of AF Taken together, these innovative acumens point to the development of new screening strategies to battle the weight, progression, and healthcare cost of AF in patients with obesity. The study included 8051 patients, and the results showed an association between Body Mass Index (BMI) and new-onset AF, where the risk for AF increases by 1% for every one-unit increase in BMI [13].
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