Obesity and AF

 Q: Obesity can be protective in atrial fibrillation (AF)? (select one)

A) Yes

B) No

Answer: A

According to the ARIC (Atherosclerosis Risk In Communities) study, 20 percent of AF is due to obesity. One of the objectives of this pearl is to introduce students to the concept of the "obesity paradox'. Interestingly, overweight and obese patients who developed AF tends to have a better prognosis, which includes a lower cardiovascular disease and all-cause mortality, when compared to lean patients with AF. This may be due to the fact that obese people adjust their hemodynamics by remodeling of left atria. Although this remodeling may result in AF but provide some protective effect in comparison to lean patients who develop AF due to other reasons. 

 #cardiology 

 References: 

1. Lavie CJ, Pandey A, Lau DH, et al. Obesity and Atrial Fibrillation Prevalence, Pathogenesis, and Prognosis: Effects of Weight Loss and Exercise. J Am Coll Cardiol 2017; 70:2022. 

2. Huxley RR, Lopez FL, Folsom AR, et al. Absolute and attributable risks of atrial fibrillation in relation to optimal and borderline risk factors: the Atherosclerosis Risk in Communities (ARIC) study. Circulation 2011; 123:1501.