Weight loss and atrial fibrillation: a review

Abstract

Purpose of reviewDespite technological advancements in catheter ablation, patients with atrial fibrillation often require multiple ablations, with diminishing returns depending on duration and persistence. Although early ablation is vital, modification of atrial fibrillation disease can be achieved with modification of existing risk factors. Obesity is an important modifiable risk factor, but there does not appear to be a consensus on the best method or goal for weight reduction.Recent findingsThe relationship between atrial fibrillation and obesity has been acknowledged. This review examines the clinical evidence demonstrating the benefit of weight reduction in the management of atrial fibrillation. In particular, this review compares the different approaches of recent studies.SummaryOn the basis of the literature, the authors recommend a structured weight loss programme with dietary and behavioural modifications individualized to each patient and including the implementation of physical activity. Consideration of bariatric surgery is appropriate in certain patients with obesity.

Impact of Weight Loss on Atrial Fibrillation

“…AF is linked to fibrosis and increased volume of the atria, which can be caused by any of the risk factors previously mentioned [ 6 ]. As a risk factor for AF, obesity is the second most significant attributable risk factor after HTN.…”

“…Increased weight is particularly associated with AF due to the electrical pathway and structural remodeling of the atria [ 6 ]. In the heart, obesity can cause increased left atrial volume, diastolic dysfunction, left ventricular hypertrophy, fibrosis, inflammatory markers (e.g., interleukin-6, C-reactive protein), and fat content.…”