Obesity and the Risk of New-Onset Atrial Fibrillation

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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