Metabolisches Syndrom und Vorhofflimmern

Nowak, Bernd; Schmidt, Boris; Chen, Shaojie; Urbanek, Lukas; Bordignon, Stefano; Schaack, David; Chun, Julian

doi:10.1007/s00399-022-00898-0

Cited by 3 publications

(5 citation statements)

References 30 publications

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Section: Figurementioning

confidence: 99%

“…It's known that obesity itself is linked with a significantly increased risk of AF due to the association with comorbidities such as hypertension, type 2 diabetes, hyperlipidemia, and obstructive sleep apnea. 2 Weight reduction is an important treatment strategy. The LEGACY trial demonstrated that in overweight and obese individuals with symptomatic AF, progressive weight loss has a dose-dependent effect on long-term freedom from AF.…”

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confidence: 99%

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Catheter ablation of atrial fibrillation in “very severe” obese patients (BMI ≥ 40): Insights from “the ICE‐Obese Extreme” study

Chen

2024

Cardiovasc electrophysiol

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Section: Figurementioning

confidence: 99%

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confidence: 99%

Catheter ablation of atrial fibrillation in “very severe” obese patients (BMI ≥ 40): Insights from “the ICE‐Obese Extreme” study

Chen

2024

Cardiovasc electrophysiol

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“…Regarding the relationship with AF, these risk factors not only promote the appearance of this tachyarrhythmia but also contribute to its maintenance or recurrence. Correcting some of them, such as weight loss, has been associated with the success of treatment for maintaining cardiac sinus rhythm [ 103 ].…”

Section: Atrial Fibrillation Chronic Coronary Disease and Their Commo...mentioning

confidence: 99%

Atrial Fibrillation and Chronic Coronary Ischemia: A Challenging Vicious Circle

Oancea,

Jigoranu,

Morariu

et al. 2023

Life

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Atrial fibrillation, the most frequent arrhythmia in clinical practice and chronic coronary syndrome, is one of the forms of coronary ischemia to have a strong dual relationship. Atrial fibrillation may accelerate atherosclerosis and may increase oxygen consumption in the myocardium, creating a mismatch between supply and demand, thus promoting the development or worsening of coronary ischemia. Chronic coronary syndrome alters the structure and function of gap junction proteins, affecting the conduction of action potential and leading to ischemic necrosis of cardiomyocytes and their replacement with fibrous tissue, in this way sustaining the focal ectopic activity in atrial myocardium. They have many risk factors in common, such as hypertension, obesity, type 2 diabetes mellitus, and dyslipidemia. It is vital for the prognosis of patients to break this vicious circle by controlling risk factors, drug therapies, of which antithrombotic therapy may sometimes be challenging in terms of prothrombotic and bleeding risk, and interventional therapies (revascularization and catheter ablation).

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“…1,[4][5][6] Obesity, currently another serious public health issue, is linked with a significantly increased risk of AF due to its known association with comorbidities such as hypertension, type 2 diabetes, hyperlipidemia and obstructive sleep apnea. 7,8 Management of AF in very severe obese patients is challenging; typically they are highly symptomatic, have poor response to AADs or electric cardioversion. 9 Catheter ablation using traditional pointby-point modality can be technically very difficult for such patient group.…”

Section: Introductionmentioning

confidence: 99%

“…Obesity, currently another serious public health issue, is linked with a significantly increased risk of AF due to its known association with comorbidities such as hypertension, type 2 diabetes, hyperlipidemia and obstructive sleep apnea 7,8 …”

Section: Introductionmentioning

confidence: 99%

Cryoablation of atrial fibrillation in “very severe” obese patients (BMI ≥ 40): Indications, feasibility, procedural safety and efficacy, and clinical outcome (the ICE‐Obese Extreme)

Urbanek,

Schmidt,

Bordignon

et al. 2024

Cardiovasc electrophysiol

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BackgroundManagement of atrial fibrillation (AF) in very severe obese patients is challenging. Cryoballoon ablation (CBA) represents an effective rhythm control strategy. However, data in this patient group were limited.MethodsHighly symptomatic AF patients with body mass index (BMI) ≥ 40 kg/m2 who had failed antiarrhythmic drug therapy and electrocardioversion and failure to achieve targeted body‐weight‐reduction underwent CBA.ResultsData of 72 very severe obese AF patients (Group A) and 129 AF patients with normal BMI (Group B, BMI < 25 kg/m2) were consecutively collected. Group A had significantly younger age (60.6 ± 10.4 vs. 69.2 ± 11.2 years), higher BMI (44.3 ± 4.3 vs. 22.5 ± 1.6 kg/m2). Procedural pulmonary vein isolation (PVI) was successful in all patients (2 touch‐up ablation in Group A). Compared to Group B, Group A had similar procedural (61.3 ± 22.6 vs. 57.5 ± 19 min), similar fluoroscopy time (10.1 ± 5.5 vs. 9.2 ± 4.8 min) but significantly higher radiation dose (2852 ± 2095 vs. 884 ± 732 µGym2). We observed similar rates of real‐time‐isolation (78.6% vs. 78.5%), single‐shot‐isolation (86.5% vs. 88.8%), but significantly longer time‐to‐sustained‐isolation (53.5 ± 33 vs. 43.2 ± 25 s). There was significantly higher rate of puncture‐site‐complication (6.9% vs. 1.6%) in Group A. One‐year clinical success in paroxysmal AF was (Group A: 69.4% vs. Group B: 80.2%; p < .001), in persistent AF was (Group A: 58.1% vs. Group B: 62.8%; p = .889). In Re‐Do procedures Group A had a numerically lower PVI durability (75.0% vs. 83.6%, p = .089).ConclusionFor very severe obese AF patients, CBA appears feasible, leads to relatively good clinical outcome.

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Metabolisches Syndrom und Vorhofflimmern

Cited by 3 publications

References 30 publications

Catheter ablation of atrial fibrillation in “very severe” obese patients (BMI ≥ 40): Insights from “the ICE‐Obese Extreme” study

Catheter ablation of atrial fibrillation in “very severe” obese patients (BMI ≥ 40): Insights from “the ICE‐Obese Extreme” study

Atrial Fibrillation and Chronic Coronary Ischemia: A Challenging Vicious Circle

Cryoablation of atrial fibrillation in “very severe” obese patients (BMI ≥ 40): Indications, feasibility, procedural safety and efficacy, and clinical outcome (the ICE‐Obese Extreme)

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