Obesity and the risk of new-onset atrial fibrillation

Wang, T.J.; Parise, Helen; Lévy, Daniel

doi:10.1016/j.accreview.2005.02.017

Cited by 200 publications

(287 citation statements)

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“…In contrast, some studies have shown increase in QTc interval in obese subjects. [7][8][9] Our findings support the association between delayed ventricular repolarization and obesity. In the current study, we found a significant increase in QTc dispersion and Max.…”

Section: Qtc Interval and Dispersionsupporting

confidence: 86%

“…14,15 However, association between obesity and AF was not exactly clarified until recently. Wang et al 7 previously have shown that obesity is a risk factor for AF, and they observed that obesity was associated with a 50% increase in the risk of AF. Furthermore, Frost et al 16 have suggested that AF and flutter should be added to the list of diseases caused by overweight and obesity.…”

Section: P-wave Duration and Dispersionmentioning

confidence: 95%

“…P-wave dispersion, which is the difference between maximum and minimum P-wave duration, has been recently defined as a new electrographic marker for the prediction of atrial fibrillation (AF) 4 and it is found to be associated with inhomogeneous and discontinuous propagation of sinus impulses. 4,5 Although, in the Framingham Heart Study 6 body mass index (BMI) was not defined as an independent risk factor for AF, according to a recent study by Wang et al 7 obesity has proved as an important, potential risk factor for AF. The association of obesity with subsequent development of AF persists even after accounting for the influence of concominant conditions such as hypertension (HT), diabetes mellitus (DM) and myocardial infarction.…”

Section: Introductionmentioning

confidence: 99%

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Effect of obesity on P-wave dispersion and QT dispersion in women

et al. 2006

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Objective: The aim of this study was to investigate the effect of obesity on dispersion of P-wave duration and QTc interval in obese women. Methods: Forty-two obese women (Body mass index (BMI) ¼ 4073 kg/m 2 , mean age 4579 years) and compared agematched (BMI ¼ 2271 kg/m 2 , mean age 4176 years) twenty-five non-obese women were included in our study. Maximum and minimum P-wave duration, P-wave dispersion (difference between the maximum and the minimum P-wave duration), maximum and minimum QTc interval, and QTc dispersion (the difference between the maximum and the minimum QTc interval) were measured from 12-lead ECG. ECG's were transferred to a personal computer via a scanner and then used for magnification of 400 times by Adobe Photoshop software. Results: There was significant difference in BMI (4073 vs 2271 kg/m 2 , Po0.001, respectively) between obese and non-obese women. Obese women had higher Max. P-wave duration (116711 vs 94714 ms, Po0.001), P-wave dispersion (51715 vs 26711 ms, Po0.001), Max. QTc interval (449738 vs 419730 ms, Po0.001) and QTc dispersion (57723 vs 38715 ms, Po0.001) compared to non-obese women. A significant correlation was found between BMI and Max. P-wave duration (r ¼ 0.584, Po0.001), P-wave dispersion (r ¼ 0.621, Po0.001), Max. QTc interval (r ¼ 0.410, Po0.001), and QTc dispersion (r ¼ 0.429, Po0.001). In the linear regression analysis, compared to co-morbidity factors such as age, hypertension, diabetes mellitus and smoking, there was significant association between only BMI and electrocardiographic values (P-wave and QTc dispersion). Conclusion: We concluded that obesity caused significant increase in P-wave and QTc dispersion. Therefore, obese women may not only be under the risk of ventricular arrhythmias, but also they may under the risk of atrial arrhythmias.

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Section: Qtc Interval and Dispersionsupporting

confidence: 86%

Section: P-wave Duration and Dispersionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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Effect of obesity on P-wave dispersion and QT dispersion in women

et al. 2006

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“…Unlike most prior studies, we adjusted for BMI, and so our findings support an independent association of diabetes with atrial fibrillation beyond the known association with obesity. 20,28,29 A large proportion (39%) of our cases had "transitory" atrial fibrillation, defined as a single episode lasting 7 days or less without recurring in the ensuing 6 months. Many prior studies did not report information about duration or persistence of 11,13,14,16,17,19,20,[25][26][27] or used a classification scheme not directly comparable to ours.…”

Section: Discussionmentioning

confidence: 99%

“…3,9,11,14,17,19,[22][23][24][25][26][27] Many studies did not adjust for obesity, which is associated with increased risk of both diabetes and atrial fibrillation. 20,28,29 No study has examined the potential role of diabetes duration or glycemic control. We used data from a large case-control study of newly-recognized atrial fibrillation 30 to examine the relationship between diabetes and risk of atrial fibrillation and to explore whether risk differs by diabetes duration and glycemic control.…”

Section: Introductionmentioning

confidence: 99%

Diabetes Mellitus, Glycemic Control, and Risk of Atrial Fibrillation

et al. 2010

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BACKGROUND: Diabetes may be an independent risk factor for atrial fibrillation. However, results from prior studies are in conflict, and no study has examined diabetes duration or glycemic control. OBJECTIVE: To examine the association of diabetes with risk of atrial fibrillation and to describe risk according to diabetes duration and glycemic control. DESIGN: A population-based case-control study. PARTICIPANTS: Within a large, integrated healthcare delivery system, we identified 1,410 people with newlyrecognized atrial fibrillation from ICD-9 codes and validated cases by review of medical records. 2,203 controls without atrial fibrillation were selected from enrollment lists, stratified on age, sex, hypertension, and calendar year. MAIN MEASURES: Information on atrial fibrillation, diabetes and other characteristics came from medical records. Diabetes was defined based on physician diagnoses recorded in the medical record, and pharmacologically treated diabetes was defined as receiving antihyperglycemic medications. Information about hemoglobin A1c levels came from computerized laboratory data. KEY RESULTS: Among people with atrial fibrillation, 252/1410 (17.9%) had pharmacologically treated diabetes compared to 311/2203 (14.1%) of controls. The adjusted OR for atrial fibrillation was 1.40 (95% CI 1.15-1.71) for people with treated diabetes compared to those without diabetes. Among those with treated diabetes, the risk of developing atrial fibrillation was 3% higher for each additional year of diabetes duration (95% CI 1-6%). Compared to people without diabetes, the adjusted OR for people with treated diabetes with average hemoglobin A1c ≤7 was 1.06 (95% CI 0.74-1.51); for A1c >7 but ≤8, 1.48 (1.09-2.01); for A1c >8 but ≤9, 1.46 (1.02-2.08); and for A1c >9, 1.96 (1.22-3.14). CONCLUSIONS: Diabetes was associated with higher risk of developing atrial fibrillation, and risk was higher with longer duration of treated diabetes and worse glycemic control. Future research should identify and test approaches to reduce the risk of atrial fibrillation in people with diabetes.

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