Increases in body mass index (BMI) may significantly raise the risk of incident, post-operative and post-ablation atrial fibrillation (AFib) according to a new study published May 27 in JACC: Clinical Electrophysiology.

The researchers, led by Christopher X. Wong, MBBS, MSc, from the Centre for Heart Rhythm Disorders at the South Australian Health and Medical Research Institute at the University of Adelaide and the Royal Adelaide Hospital in Adelaide, Australia, examined data from 51 studies including 626,603 participants. Studies were included if they were cross-sectional case-control or cohort studies that allowed for assessment of associations between BMI and incident AFib, post-operative AFib or post-ablation AFib.

Overall results found that for every five unit increase in BMI, there was a 19-29 percent greater risk of developing AFib; a 10 percent greater excess risk of post-operative AFib; and a 13 percent greater excess risk of recurrent AFib post-ablation.

"By providing a comprehensive and reliable quantification of the relationship between incremental increases in obesity and AFib across different clinical settings, our findings highlight the potential for even moderate reductions in population body mass indexes to have a significant effect in mitigating the rising burden of AFib," the study investigators noted.

Moving forward, they suggest that further studies are warranted to characterize the effect that weight reduction may have not only in preventing incident AFib, but also in managing patients with established AFib.

"The results of this study show that even moderate reductions in population BMI potentially could significantly reduce the burden of AFib," said Craig T. January, MD, PhD, writing committee chair of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With AFib. "A decrease in obesity would also lower rates of conditions such as diabetes and hypertension, which are also risk factors for AFib and would therefore have a greater impact on reducing this condition."

Keywords: Obesity, Body Mass Index, Arrhythmias, Cardiac, Atrial Fibrillation, Catheter Ablation, Cohort Studies, Cross-Sectional Studies, Diabetes Mellitus, Electrophysiology, Hypertension, Risk Factors, Weight Loss

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