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Obesity effect on newly diagnosed and recurrent post-ablation atrial fibrillation: a systematic review and meta-analysis

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Abstract

Background and aims

The role of overweight and obesity in the development of atrial fibrillation (AF) is well established; however, the differential effect on the occurrence and recurrence of AF remains uncertain. The aim of this review is to compare the effect of underweight and varying degrees of obesity on onset of AF and in recurrent post-ablation AF, and, when possible, in relation to sex.

Methods

A systematic literature search was conducted in PubMed, Embase, and Cochrane Library from inception to January 31, 2023. Studies reporting frequency of newly-diagnosed AF and of recurrent post-ablation AF in different BMI categories, were included. 3400 records were screened and 50 met the inclusion criteria. Standardized data search and abstraction were performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Statement. Data were extracted from the manuscripts and were analyzed using a random effect model. The outcome was the occurrence of AF in population studies and in patients undergoing ablation.

Results

Data from 50 studies were collected, of which 27 for newly-diagnosed AF and 23 for recurrent post-ablation AF, for a total of 15,134,939 patients, of which 15,115,181 in studies on newly-diagnosed AF and 19,758 in studies on recurrent post-ablation AF. Compared to normal weight, the increase in AF was significant (p < 0.01) for overweight, obese, and morbidly obese patients for newly-diagnosed AF, and for obese and morbidly obese patients for recurrent post-ablation AF. Newly-diagnosed AF was more frequent in obese female than obese male patients.

Conclusion

The effect of increased BMI was greater on the onset of AF, and obese women were more affected than men.

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Data availability

Data are available from the corresponding author on the basis of reasonable request.

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Acknowledgements

This study was supported by a grant (Ricerca Corrente) of the Italian Ministry of Health (Ministero della Salute) to IRCCS MultiMedica.

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Authors and Affiliations

  1. Department of Health Sciences, University of Milan, Via A. Di Rudinì 8, 20142, Milan, Italy

    F. Folli, L. Centofanti, M. Bignotto & A. E. Pontiroli

  2. Division of Cardiology, Ospedale San Paolo, 20142, Milan, Italy

    S. Magnani

  3. Laboratory of Cardiovascular and Dysmetabolic Diseases, PST-Via Fantoli 18/15, 20138, Milan, Italy and Value-Based Healthcare Unit, IRCCS MultiMedica, 20099, Sesto San Giovanni, Milan, Italy

    E. Tagliabue & L. La Sala

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  1. F. Folli
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Folli, F., Centofanti, L., Magnani, S. et al. Obesity effect on newly diagnosed and recurrent post-ablation atrial fibrillation: a systematic review and meta-analysis. J Endocrinol Invest 47, 1051–1066 (2024). https://doi.org/10.1007/s40618-023-02225-x

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