Impact of Obesity on Atrial Fibrillation Pathogenesis and Treatment Options
ABSTRACT Atrial fibrillation (AF) is the most common cardiac arrhythmia. AF increases the risk of stroke, heart failure, dementia, and hospitalization. Obesity significantly increases AF risk, both directly and indirectly, through related conditions, like hypertension, diabetes, and heart failure. O...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-01-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.032277 |
| _version_ | 1797229346504572928 |
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| author | Rina Sha Olivia Baines Abbie Hayes Katie Tompkins Manish Kalla Andrew P. Holmes Christopher O'Shea Davor Pavlovic |
| author_facet | Rina Sha Olivia Baines Abbie Hayes Katie Tompkins Manish Kalla Andrew P. Holmes Christopher O'Shea Davor Pavlovic |
| author_sort | Rina Sha |
| collection | DOAJ |
| description | ABSTRACT Atrial fibrillation (AF) is the most common cardiac arrhythmia. AF increases the risk of stroke, heart failure, dementia, and hospitalization. Obesity significantly increases AF risk, both directly and indirectly, through related conditions, like hypertension, diabetes, and heart failure. Obesity‐driven structural and electrical remodeling contribute to AF via several reported mechanisms, including adiposity, inflammation, fibrosis, oxidative stress, ion channel alterations, and autonomic dysfunction. In particular, expanding epicardial adipose tissue during obesity has been suggested as a key driver of AF via paracrine signaling and direct infiltration. Weight loss has been shown to reverse these changes and reduce AF risk and recurrence after ablation. However, studies on how obesity affects pharmacologic or interventional AF treatments are limited. In this review, we discuss mechanisms by which obesity mediates AF and treatment outcomes, aiming to provide insight into obesity‐drug interactions and guide personalized treatment for this patient subgroup. |
| first_indexed | 2024-03-08T13:50:43Z |
| format | Article |
| id | doaj.art-dd5b63d0baeb449bba280cb530bcf389 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-24T15:11:08Z |
| publishDate | 2024-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-dd5b63d0baeb449bba280cb530bcf3892024-04-02T11:32:06ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-01-0113110.1161/JAHA.123.032277Impact of Obesity on Atrial Fibrillation Pathogenesis and Treatment OptionsRina Sha0Olivia Baines1Abbie Hayes2Katie Tompkins3Manish Kalla4Andrew P. Holmes5Christopher O'Shea6Davor Pavlovic7Institute of Cardiovascular Sciences, University of Birmingham Birmingham United KingdomInstitute of Cardiovascular Sciences, University of Birmingham Birmingham United KingdomInstitute of Cardiovascular Sciences, University of Birmingham Birmingham United KingdomInstitute of Cardiovascular Sciences, University of Birmingham Birmingham United KingdomInstitute of Cardiovascular Sciences, University of Birmingham Birmingham United KingdomInstitute of Cardiovascular Sciences, University of Birmingham Birmingham United KingdomInstitute of Cardiovascular Sciences, University of Birmingham Birmingham United KingdomInstitute of Cardiovascular Sciences, University of Birmingham Birmingham United KingdomABSTRACT Atrial fibrillation (AF) is the most common cardiac arrhythmia. AF increases the risk of stroke, heart failure, dementia, and hospitalization. Obesity significantly increases AF risk, both directly and indirectly, through related conditions, like hypertension, diabetes, and heart failure. Obesity‐driven structural and electrical remodeling contribute to AF via several reported mechanisms, including adiposity, inflammation, fibrosis, oxidative stress, ion channel alterations, and autonomic dysfunction. In particular, expanding epicardial adipose tissue during obesity has been suggested as a key driver of AF via paracrine signaling and direct infiltration. Weight loss has been shown to reverse these changes and reduce AF risk and recurrence after ablation. However, studies on how obesity affects pharmacologic or interventional AF treatments are limited. In this review, we discuss mechanisms by which obesity mediates AF and treatment outcomes, aiming to provide insight into obesity‐drug interactions and guide personalized treatment for this patient subgroup.https://www.ahajournals.org/doi/10.1161/JAHA.123.032277antiarrhythmic drugsatrial fibrillationepicardial adipose tissueion channelobesity |
| spellingShingle | Rina Sha Olivia Baines Abbie Hayes Katie Tompkins Manish Kalla Andrew P. Holmes Christopher O'Shea Davor Pavlovic Impact of Obesity on Atrial Fibrillation Pathogenesis and Treatment Options Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease antiarrhythmic drugs atrial fibrillation epicardial adipose tissue ion channel obesity |
| title | Impact of Obesity on Atrial Fibrillation Pathogenesis and Treatment Options |
| title_full | Impact of Obesity on Atrial Fibrillation Pathogenesis and Treatment Options |
| title_fullStr | Impact of Obesity on Atrial Fibrillation Pathogenesis and Treatment Options |
| title_full_unstemmed | Impact of Obesity on Atrial Fibrillation Pathogenesis and Treatment Options |
| title_short | Impact of Obesity on Atrial Fibrillation Pathogenesis and Treatment Options |
| title_sort | impact of obesity on atrial fibrillation pathogenesis and treatment options |
| topic | antiarrhythmic drugs atrial fibrillation epicardial adipose tissue ion channel obesity |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.032277 |
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