Obesity and postoperative atrial fibrillation in patients undergoing cardiac surgery: Systematic review and meta-analysis

Phan, Kevin; Khuong, Jacqueline Nguyen; Xu, Joshua; Kanagaratnam, Aran; Yan, Tristan D.

doi:10.1016/j.ijcard.2016.05.002

Cited by 43 publications

(42 citation statements)

References 59 publications

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“…K. Phan et al [16] published meta-analysis, trying to define the relationship between obesity and POAF, as obesity is associated with dilated left atrium and diastolic dysfunction, triggers of POAF [1]. The analysis revealed a higher risk of POAF in obese or hypertensive patients.…”

Section: Discussionmentioning

confidence: 99%

Relation of body mass index to postoperative atrial fibrillation

Iliescu¹,

Corciova²,

Achiței³

et al. 2018

CSIC

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P ostoperative atrial fibrillation (POAF) is a most common complication of cardiac surgery. Its incidence depends on the surgery type and is estimated at 40-50 % in valvular surgery cases [18]. The arrhythmia is associated with high risk of stroke, increased early and late mortality, and considerable costs. Advanced age is consistently reported to be an independent risk factor for arrhythmic complications. Increasing life expectancy caused a growing number of replaced aortic valves [2, 12, 23]. Patients undergoing aortic valve replacement have many comorbidities with cumulative arrhythmic risk; therefore, prophylactic management is needed. Postoperative atrial fibrillation can occur anytime, mostly 2 to 4 days after surgery but possibly

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Section: Discussionmentioning

confidence: 99%

Relation of body mass index to postoperative atrial fibrillation

Iliescu¹,

Corciova²,

Achiței³

et al. 2018

CSIC

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“…After adjusting for age, sex and independent BMI predicted progression to permanent AF; obesity was shown to catalyse the advancement of paroxysmal AF to permanent AF (56). Obesity has also been associated with a moderately higher risk of AF following cardiac surgery (57). Additionally, more than 70% of subjects with obstructive sleep apnoea (OSA) are overweight or obese (58,59).…”

Section: Pathophysiologymentioning

confidence: 99%

Atrial fibrillation: review of current treatment strategies

Xu¹,

Luc²,

Phan³

2016

J. Thorac. Dis.

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Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia in modern clinical practice, with an estimated prevalence of 1.5-2%. The prevalence of AF is expected to double in the next decades, progressing with age and increasingly becoming a global medical challenge. The first-line treatment for AF is often medical treatment with either rate control or anti-arrhythmic agents for rhythm control, in addition to anti-coagulants such as warfarin for stroke prevention in patient at risk. Catheter ablation has emerged as an alternative for AF treatment, which involves myocardial tissue lesions to disrupt the underlying triggers and substrates for AF. Surgical approaches have also been developed for treatment of AF, particularly for patients requiring concomitant cardiac surgery or those refractory to medical and catheter ablation treatments. Since the introduction of the Cox-Maze III, this procedure has evolved into several modern variations, including the use of alternative energy sources (Cox-Maze IV) such as radiofrequency, cryo-energy and microwave, as well as minimally invasive thoracoscopic epicardial approaches. Another recently introduced technique is the hybrid ablation approach, where in a single setting both epicardial thoracoscopic ablation lesions and endocardial catheter ablation lesions are performed by the cardiothoracic surgeon and cardiologist. There remains controversy surrounding the optimal approach for AF ablation, energy sources, and lesion sets employed. The goal of this article is review the history, classifications, pathophysiology and current treatment options for AF.

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“…A close association has been reported between obesity and atrial brillation [5]. However, almost all studies reporting such association have used the Body Mass Index (BMI, Kg/m 2 ) to evaluate weight excess [6].…”

Section: Introductionmentioning

confidence: 99%

Overweight and Aging Increase the Risk of Atrial Fibrillation After Cardiac Surgery Independently of Left Atrial Size and Left Ventricular Ejection Fraction

Stefàno

Bugetti

Monaco

et al. 2020

Preprint

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Background: Body mass index (BMI), age, left atrium (LA) dimensions and left ventricular ejection fraction (LVEF) have been linked to post-operative atrial fibrillation (POAF) after cardiac surgery. The aim was to better define the role of these risk factors. Methods: This study evaluated 249 patients (without prior atrial dysrhythmia) undergoing cardiac or aortic surgery . Prior to surgery the following data were collected: age (yrs), BMI (kg/m2), LA diameter (cm), LA area (cm2), LVEF (%), the presence of arterial hypertension (AH) and of diabetes, tyroid stimulating hormone (TSH, mU/L) and, creatinine (mg/dL). Results: Patients with (n. 127, 51%) and without POAF (n. 122, 49%) were compared. No difference was observed for sex, LA diameter, LA area, LVEF, TSH and diabetes. Instead, patients with PoAF had higher values of age, BMI, creatinine and a greater prevalence of AH and Bentall procedures. Multivariable analysis showed that the only independent predictors of PoAF were: age (OR = 1,05, CI 95% 1,025-1,076, p= 0,0001) and BMI (OR=1,095, CI 95% 1,015-1,182, p= 0,019). Conclusions: Results suggest that advanced age and a higher value of BMI are strong risk factors for POAF in patients without previous AF. This even in the presence of comparable LA dimensions and LVEF.

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Obesity and postoperative atrial fibrillation in patients undergoing cardiac surgery: Systematic review and meta-analysis

Cited by 43 publications

References 59 publications

Relation of body mass index to postoperative atrial fibrillation

Relation of body mass index to postoperative atrial fibrillation

Atrial fibrillation: review of current treatment strategies

Overweight and Aging Increase the Risk of Atrial Fibrillation After Cardiac Surgery Independently of Left Atrial Size and Left Ventricular Ejection Fraction

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