Outcomes With Novel Oral Anticoagulants in Obese Patients who Underwent Electrical Cardioversion for Atrial Tachyarrhythmias

Kaplan, Rachel; Diaz, Celso L.; Strzelczyk, Theresa; You, Cindy; Saour, Basil; Fine, Michelle; Trivedi, Amar; Shen, Mark J.; Sattayaprasert, Prasongchai; Chicos, Alexandru B.; Arora, Rishi; Kim, Susan; Lin, Albert; Verma, Nishant; Knight, Bradley P.; Passman, Rod

doi:10.1016/j.amjcard.2018.06.022

Cited by 6 publications

(3 citation statements)

References 17 publications

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“…[77] Kaplan et al recently evaluated obese patients including those with a BMI >40 kg/m 2 undergoing direct current cardioversion (DCCV) for AF or atrial flutter on DOACs and warfarin and found there was a very low incidence of stroke with none seen in the BMI >40 kg/m 2 cohort at 30 days. [78] While the patient cohort group consisted of only 761 patients, this study would suggest DOACs appear to be safe in a cohort who have a relatively elevated risk for stroke in the first month post-DCCV.…”

Section: Management Of Af In Obese Patientsmentioning

confidence: 99%

Obesity and Atrial Fibrillation: Epidemiology, Pathophysiology and Novel Therapeutic Opportunities

Vyas

Lambiase

2019

Arrhythm Electrophysiol Rev

104

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Obesity is already a major global public health issue, implicated in a vast array of conditions affecting multiple body systems. It is now also firmly established as an independent risk factor in the incidence and progression of AF. The rapidly rising morbidity, mortality and healthcare costs associated with AF despite implementation of the three pillars of AF management – anticoagulation, rate control and rhythm control – suggest other strategies need to be considered. Compelling data has unveiled novel insights into adipose tissue biology and its effect on arrhythmogenesis while secondary prevention strategies targeting obesity as part of a comprehensive risk factor management programme have been demonstrated to be highly effective. Here, the authors review the epidemiological basis of the obesity–AF relationship, consider its underlying pathophysiology and discuss new therapeutic opportunities on the horizon.

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Section: Management Of Af In Obese Patientsmentioning

confidence: 99%

Obesity and Atrial Fibrillation: Epidemiology, Pathophysiology and Novel Therapeutic Opportunities

Vyas

Lambiase

2019

Arrhythm Electrophysiol Rev

104

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“…In many centers, however, preprocedural imaging is not standard practice. Therefore, availability of real-world studies of pericardioversion DOAC is important [10][11][12][13][14][15][16][17][18]. Of these real-world studies, 2 single-center studies had a larger sample size than our study, however, in both studies approximately one-fifth of procedures were guided by TEE [11,17].…”

Section: J O U R N a L P R E -P R O O Fmentioning

confidence: 99%

Efficacy and safety of direct oral anticoagulants in patients undergoing elective electrical cardioversion: A real-world patient population

Heide¹,

Wit

Bhagwandien

et al. 2021

International Journal of Cardiology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…This group of patients may, therefore, benefit from DOAC; however, futher research is required in this field. For example, the study performed by Kapla et al evaluating obese patients including a subgroup of morbidly obese treated with warfarin or DOAC undergoing electrical cardioversion (ECV) for AF showed a very low incidence of stroke (with no stroke in the subgroup with the BMI > 40 kg/m 2 ) one month after the procedure [ 21 ]. This approach is supported by the recent metanalysis comparing the efficacy and safety of the DOAC in obese and nonobese patients with AF, which demonstrated that obese patients taking t DOAC had a lower risk of stroke/systemic embolism and a similar risk of bleeding compared to the nonobese ones [ 22 ].…”

Section: Obesity and Afmentioning

confidence: 99%

Obesity as a risk factor in atrial fibrillation and heart failure

Jurica,

Péč,

Benko

et al. 2023

J Diabetes Metab Disord

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Objectives The aim of this article is to provide an insight into the role of obesity as a risk factor, and as a potential etiologic agent of atrial fibrillation (AF) and heart failure (HF). Methods A narrative (non-systematic) review article summarizing currently available data regarding the interaction between obesity, AF and HF. Results Obesity is considered a risk factor of AF and chronic HF. Multiple recent studies indicate that obesity is also a potential causal factor in the development of AF and HF, the elucidation of pathological mechanisms of which could help devise new diagnostic and therapeutic modalities for these conditions. The discussion about obesity in relation to HF cannot omit the so-called obesity paradox, which represents a dilemma for clinicians, and it is still a source of irregularities regarding the strategy of weight reduction in obese patients with HF. Recently, the obesity paradox has also been assumed to play a role in the relationship between obesity and thromboembolic complications of AF. Conclusions Obesity is an independent and modifiable risk factor for AF and HF. In addition, there is an increasing volume of experimental and clinical data that suggests an important role of the epicardial adipose tissue in the pathophysiology of AF. However, several issues, such as the issue of optimal pharmacotherapy and weight reduction strategy in obese patients with HF remains still unanswered, and open for future investigation.

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Outcomes With Novel Oral Anticoagulants in Obese Patients who Underwent Electrical Cardioversion for Atrial Tachyarrhythmias

Cited by 6 publications

References 17 publications

Obesity and Atrial Fibrillation: Epidemiology, Pathophysiology and Novel Therapeutic Opportunities

Obesity and Atrial Fibrillation: Epidemiology, Pathophysiology and Novel Therapeutic Opportunities

Efficacy and safety of direct oral anticoagulants in patients undergoing elective electrical cardioversion: A real-world patient population

Obesity as a risk factor in atrial fibrillation and heart failure

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