The incidence of cardiac arrhythmias during exercise stress testing: a focus on patients with severe obesity undergoing sleeve gastrectomy

Abstract

Introduction: Obesity is associated with a higher risk of cardiac arrhythmias. Sleeve Gastrectomy (SG) is a common bariatric surgery with bene cial effects on weight loss and comorbidities. The study aimed to investigate the prevalence of arrhythmias during maximal exercise testing in patients with moderatesevere obesity and to evaluate the impact of SG on these arrhythmic events. Methods: All patients with moderate or severe obesity who were considered suitable candidates for SG between June 2015 and September 2020 were recruited. Each patient underwent three incremental, maximal, ECG-monitored cardiopulmonary exercise test one month before and six and twelve months after SG; the frequency and complexity of ventricular premature beats (VPBs) and atrial premature beats (APBs) have been evaluated during rest, exercise and recovery phases.Results: 50 patients with severe obesity (BMI 46.39 ±7.89 kg/m2) were included in the study. After SG, patients presented a decreased BMI (34.15 ± 6.25 kg/m2 at six months post-SG and 31.87 ± 5.99 kg/m2 at twelve months post-SG). At six months post-SG, an increase in VPBs, mainly during the recovery phase, was observed. At twelve months post-SG, a reduction in VPBs compared with the six months evaluation was showed.Conclusion: Although in the early post-surgical phase the risk of exercise-induced arrhythmias may be higher, SG does not seem to increase the occurrence of arrhythmias in the long-term. No life-threating arrhythmias were found during post-SG evaluations.