Obesity and the Risk of New-Onset Atrial Fibrillation

Abstract

The prevalence of atrial fibrillation (AF), the most common cardiac dysrhythmia, is expected to increase several-fold in the coming decades.¹ Because the onset of AF is associated with considerable morbidity and mortality despite contemporary therapies, the identification of potentially modifiable risk factors for AF is an important goal.^2,3 Prior studies have demonstrated that advanced age, diabetes, hypertension, and cardiovascular disease increase the risk of developing AF.^4-7 Obesity occurs in association with most of these conditions, but it is unclear whether obesity itself predisposes to AF. The rationale for hypothesizing such a link comes from experimental and clinical data suggesting that adiposity influences atrial and ventricular structure,^8-11 autonomic tone,¹² and ventricular diastolic function.¹³ Prior epidemiologic studies have yielded conflicting results regarding whether obesity is a risk factor for AF, but these studies were potentially limited by short-term follow-up, failure to account for interim cardiovascular events, and lack of echocardiographic data.^4-7