Skip to main content
SpringerLink
Log in

Assessment of Atrial Fibrillation and Ventricular Arrhythmia Risk after Bariatric Surgery by P Wave/QT Interval Dispersion

  • Original Contributions
  • Published:
Obesity Surgery Aims and scope Submit manuscript

Abstract

Background

The association of obesity with atrial fibrillation (AF) and with ventricular arrhythmias is well documented.

Objective

The aim of this study was to investigate whether weight reduction by a laparoscopic sleeve gastrectomy has any effect on P wave dispersion (PWD), a predictor of AF, and corrected QT interval dispersion (CQTD), a marker of ventricular arrhythmias, in obese individuals.

Methods

In a prospective study, a total of 114 patients (79 females, 35 males) who underwent laparoscopic sleeve gastrectomy were examined. The patients were followed 1 year. PWD and CQTD values before and 3rd, 6th, and 12th months after the surgery were calculated and compared.

Results

There was a statistically significant decline in body mass index (BMI), PWD, and CQTD values among baseline, 3rd, 6th, and 12th months (p < 0.001 for all comparisons). Correlation analysis showed a statistically significant correlation between ΔPWD and ΔBMI (r = 0.719, p < 0.001), ΔPWD and Δleft ventricular end-diastolic diameter (LVEDD) (r = 0.291, p = 0.002), ΔPWD and Δleft atrial diameter (LAD) (r = 0.65, p < 0.001), ΔCQTD and ΔBMI (r = 0.266, p = 0.004), ΔCQTD and ΔLVEDD (r = 0.35, p < 0.001), ΔCQTD and ΔLAD (r = 0.289, p = 0.002). In multiple linear regression analysis, there was a statistically significant relationship between ΔPWD and ΔBMI (β = 0.713, p < 0.001), ΔPWD and ΔLVEDD (β = 0.174, p = 0.016), ΔPWD and ΔLAD (β = 0.619, p < 0.001), ΔCQTD and ΔBMI (β = 0.247, p = 0.011), ΔCQTD and ΔLVEDD (β = 0.304, p < 0.001), ΔCQTD and ΔLAD (β = 0.235, p = 0.009).

Conclusion

PWD and CQTD values of patients were shown to be attenuated after bariatric surgery. These results indirectly offer that there may be a reduction in risk of AF, ventricular arrhythmia, and sudden cardiac death after obesity surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Jensen MD, Ryan DH, Apovian CM, et al. American College of Cardiology/American Heart Association Task Force on Practice Guidelines.; Obesity Society. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. J Am Coll Cardiol. 2014;63(25 Pt B):2985–3023.

    Article  PubMed  Google Scholar 

  2. Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980– 2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;384:766–81.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Hatem SN. Atrial fibrillation and obesity: not just a coincidence. J Am Coll Cardiol. 2015;66(1):12–3.

    Article  PubMed  Google Scholar 

  4. Narayanan K, Zhang L, Kim C, et al. QRS fragmentation and sudden cardiac death in the obese and overweight. J Am Heart Assoc 2015;4(3):e001654.

  5. Okutucu S, Aytemir K, Oto A. P-wave dispersion: what we know till now? JRSM Cardiovasc Dis 2016:21;5:2048004016639443.

  6. DE Maria E, Curnis A, Garyfallidis P, et al. QT dispersion on ECG Holter monitoring and risk of ventricular arrhythmias in patients with dilated cardiomyopathy. Heart Int. 2006;2(1):33.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Higham PD, Campbell RW. QT dispersion. Br Heart J. 1994;71(6):508–10.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Azagury DE, Morton JM. Bariatric surgery: overview of procedures and outcomes. Endocrinol Metab Clin North Am. 2016;45:647–56.

    Article  PubMed  Google Scholar 

  9. Nocca D, Loureiro M, Skalli EM, et al. Five-year results of laparoscopic sleeve gastrectomy for the treatment of severe obesity. Surg Endosc. 2017;31(8):3251–7.

  10. Kehagias I, Zygomalas A, Karavias D, et al. Sleeve gastrectomy: have we finally found the holy grail of bariatric surgery? A review of the literature. Eur Rev Med Pharmacol Sci. 2016;20(23):4930–42.

    CAS  PubMed  Google Scholar 

  11. Lang RM, Badano LP, Mor-Avi V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28:1–39.

    Article  PubMed  Google Scholar 

  12. Kligfield P, Gettes LS, Bailey JJ, et al. Recommendations for the standardization and interpretation of the electrocardiogram: part I: the electrocardiogram and its technology a scientific statement from the American Heart Association Electrocardiography and Arrhythmias Committee, Council on Clinical Cardiology; the American College of Cardiology Foundation; and the Heart Rhythm Society endorsed by the International Society for Computerized Electrocardiology. J Am Coll Cardiol. 2007;49(10):1109–27.

    Article  PubMed  Google Scholar 

  13. Russo C, Jin Z, Homma S, et al. Effect of obesity and overweight on left ventricular diastolic function: a community-based study in an elderly cohort. J Am Coll Cardiol. 2011;57:1368–74.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Pathak RK, Middeldorp ME, Meredith M, et al. Long-term effect of goal-directed weight management in an atrial fibrillation cohort: a long-term follow-up study (LEGACY). J Am Coll Cardiol. 2015;65:2159–69.

    Article  PubMed  Google Scholar 

  15. Abed HS, Wittert GA, Leong DP, et al. Effect of weight reduction and cardiometabolic risk factor management on symptom burden and severity in patients with atrial fibrillation: a randomized clinical trial. JAMA. 2013;310(19):2050–60.

    Article  CAS  PubMed  Google Scholar 

  16. Pathak RK, Middeldorp ME, Lau DH, et al. Aggressive risk factor reduction study for atrial fibrillation and implications for the outcome of ablation: the ARREST-AF cohort study. J Am Coll Cardiol. 2014;64(21):2222–31.

    Article  PubMed  Google Scholar 

  17. Jamaly S, Carlsson L, Peltonen M, et al. Bariatric surgery and the risk of new-onset atrial fibrillation in Swedish obese subjects. J Am Coll Cardiol. 2016;68(23):2497–504.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Falchi AG, Grecchi I, Muggia C, et al. Weight loss and P wave dispersion: a preliminary study. Obes Res Clin Pract. 2014;8(6):e614–7.

    Article  PubMed  Google Scholar 

  19. Goudis CA, Korantzopoulos P, Ntalas IV, et al. Obesity and atrial fibrillation: a comprehensive review of the pathophysiological mechanisms and links. J Cardiol. 2015;66(5):361–9.

    Article  PubMed  Google Scholar 

  20. Aytemir K, Ozer N, Atalar E, et al. P wave dispersion on 12-lead electrocardiography in patients with paroxysmal atrial fibrillation. Pacing Clin Electrophysiol. 2000;23(7):1109e12.

    Article  Google Scholar 

  21. Mann WN. Hippocrates in ancient and modern times. Guys Hosp Gaz. 1952;66(1661):108–13.

    CAS  PubMed  Google Scholar 

  22. Noheria A, Teodorescu C, Uy-Evanado A, et al. Distinctive profile of sudden cardiac arrest in middle-aged vs. older adults: a community-based study. Int J Cardiol. 2013;168:3495–9.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Alpert MA. Obesity cardiomyopathy: pathophysiology and evolution of the clinical syndrome. Am J Med Sci. 2001;321:225–36.

    Article  CAS  PubMed  Google Scholar 

  24. Morse SA, Bravo PE, Morse MC, et al. The heart in obesity-hypertension. Expert Rev Cardiovasc Ther. 2005;3:647–58.

    Article  CAS  PubMed  Google Scholar 

  25. Molinari G, Sardanelli F, Zandrino F, et al. Adipose replacement and wall motion abnormalities in right ventricle arrhythmias: evaluation by MR imaging. Retrospective evaluation on 124 patients. Int J Card Imaging. 2000;16:105–15.

    Article  CAS  PubMed  Google Scholar 

  26. Ashrafi R, Yon M, Pickavance L, et al. Altered left ventricular ion channel transcriptome in a high-fat-fed rat model of obesity: insight into obesity-induced arrhythmogenesis. J Obes. 2016;2016:7127898.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

The authors would like to thank their cardiology fellows due to value contributions.

Funding

This study was approved by Baskent University Institutional Review Board and Ethics Committee and supported by Baskent University Research Funding (KA 16/281).

Author information

Authors and Affiliations

  1. Department of Cardiology, Adana Teaching and Research Center, Baskent University, Dadaloğlu Mahallesi, 2591 sokak. No: 4/A 01250 Yüreğir Adana, Türkiye, Adana, Turkey

    Mustafa Yılmaz, Abdullah Tekin & Tansel Erol

  2. Department of Cardiology, Baskent University, İzmir, Turkey

    Cihan Altın

  3. Department of General Surgery, Baskent University, Adana, Turkey

    İlker Arer, Tarık Zafer Nursal & Nurkan Törer

  4. Department of General Surgery, Baskent University, İzmir, Turkey

    Varlık Erol

  5. Department of Cardiology, Baskent University, Ankara, Turkey

    Haldun Müderrisoğlu

Authors
  1. Mustafa Yılmaz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cihan Altın
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Abdullah Tekin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tansel Erol
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. İlker Arer
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Tarık Zafer Nursal
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Nurkan Törer
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Varlık Erol
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Haldun Müderrisoğlu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mustafa Yılmaz.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent Statement

After giving detailed information about the study, informed consent (writing) was obtained from all individual participants included in the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yılmaz, M., Altın, C., Tekin, A. et al. Assessment of Atrial Fibrillation and Ventricular Arrhythmia Risk after Bariatric Surgery by P Wave/QT Interval Dispersion. OBES SURG 28, 932–938 (2018). https://doi.org/10.1007/s11695-017-2923-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-017-2923-z

Keywords

Search

Navigation