Research
Mixed
Epicardial adipose tissue volume is a stronger predictor of atrial fibrillation risk than general anthropometric indices like BMI or waist circumference.
Fat stored directly around the heart (epicardial fat) is a major driver of atrial fibrillation in obese people. This risk is higher than what BMI alone suggests. Weight loss reduces this fat and improves heart rhythm.
GoodQualifiesHIGH confidence
arrhythmic risk related to obesity is at least partly attributable to epicardial adipose tissue... epicardial adipose tissue 2.61 (1.89 to 3.60), suggesting arrhythmic risk related to obesity is at least partly attributable to epicardial adipose tissue.
Why this rating
Supported by meta-analyses and cohort studies.
Source
Obesity as a risk factor for cardiac arrhythmias
Kiran Haresh Kumar Patel et al. · BMJ Medicine · 2022
DOI 10.1136/bmjmed-2022-000308
narrative_reviewCited 35×
Read the paper DOI resolved against Crossref · corpus check 2026-06-10
More from this paper
- Obesity is an independent proarrhythmic risk factor for both atrial and ventricular arrhythmias, mediated by structural remodeling (atrial/ventricular dilation, epicardial fat infiltration) and electrophysiological changes (prolonged QTc, P-wave dispersion).Strong
- Weight loss, particularly >10% body weight reduction, significantly reduces atrial fibrillation burden and increases the probability of arrhythmia-free survival.Good
- Bariatric surgery reduces all-cause and cardiovascular mortality and heart failure incidence, but its effect on reducing *incident* atrial fibrillation is not statistically significant.Good
Related findings · Mixed
- Bariatric surgery (VSG and RYGB) is the most effective and sustainable treatment for obesity, producing marked and sustained weight loss that non-surgical interventions cannot match.Strong
- Severely protein-deficient diets (2–3% energy) induce lean body mass loss and metabolic imbalance, whereas adequate protein intake (0.66 g/kg/d minimum) is a prerequisite for maintaining muscle, bone, and physiological function.Strong
- For patients with Class III obesity (BMI >39.9 kg/m2), metabolic bariatric surgery (MBS) is significantly more effective than any currently approved medication, with BilioPancreatic Diversion (BPD) showing the highest estimated weight loss.Strong
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