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Bariatric Surgery Mitigates Afib Risk

Mar
10

Date: March 10th, 2017

Bariatric Surgery and AFib

A sub-study done on bariatric surgery patients, they recorded a 29 percent reduced rate of developing atrial fibrillation as opposed to the non-surgery group. These patients were subjected to almost 20 years follow up as explained by the study lead author Shabbar Jamaly, MD, of the University of Gothenburg in Sweden, and colleagues.

The other finding of the study was that younger patients receiving bariatric surgery benefited the most as they recorded a much more reduction in the risk of developing atrial fibrillation (P=0.001 for interaction). The benefit was also shared by patients who previously had higher diastolic blood pressure (P=0.028).

Study and editorial conflict

The findings of this study as well as an accompanying conflicting editorial were posted in the Journal of the American College of Cardiology.

During a past interview, Kristjan Karason, MD, PhD, study co-author from the University of Gothenburg, stated that “To our knowledge, this is the first time weight-loss has been reported as reducing the risk of new-onset atrial fibrillation. Our findings are important since the consequences of this arrhythmia are serious, including stroke, heart failure, and increased all-cause mortality.”

In an accompanying editorial that appeared to conflict with the study, Jonathan M. Kalman, PhD, of Royal Melbourne Hospital in Australia, and colleagues criticized the trial and said that this was an observational study design that failed to match groups correctly. It also showcased absence of incident AF as a predefined endpoint.

Their suggestion was that the surgery cohort may have aimed specifically at losing weight because they opted to go for surgical treatment. Validating such results would not only be difficult but also impossible since the “degree of weight loss is not replicable in a nonsurgical context.”

Generally, the surgical cohort recorded a 25 percent reduction in the body weight loss in one year as opposed to zero change on the control mention in first aid certification.

Obesity and AF linked from past studies

It is apparent that obesity causes an increase in cardiovascular problems, atrial fibrillation included, and thus the researchers were hopeful to come up with a more dynamic “primary preventive strategy” that would lower “cardiovascular morbidity and mortality.”

They based on previously done studies to reveal that AF and obesity have a direct connection. Between 1987 and 2011, exactly 4,021 Swedish took part in a study. 2,021 got “usual care” as defined in the health care routine while the other 2,000 underwent surgery. At the time of enrollment, the participants had an average body mass index of 36, no history of atrial fibrillation and a normal sinus.

13 percent of the participants who were subjected to bariatric surgery had post-surgical complications and 2.8% of them had to undergo additional surgery. Two people from the usual care group and 5 from the surgery cohort died while the trial was still ongoing.

The researchers said that there was an independent link between atrial fibrillation and higher free thyroxine levels during the trial which could be attributed to a relationship between “subclinical hyperthyroidism,” and “the development of supraventricular arrhythmia in obesity.”

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