PMID- 32301327
OWN - NLM
STAT- MEDLINE
DCOM- 20201109
LR  - 20201109
IS  - 1941-3084 (Electronic)
IS  - 1941-3084 (Linking)
VI  - 13
IP  - 5
DP  - 2020 May
TI  - Heterogeneity in Conduction Underlies Obesity-Related Atrial Fibrillation 
      Vulnerability.
PG  - e008161
LID - 10.1161/CIRCEP.119.008161 [doi]
AB  - BACKGROUND: Obese patients are more vulnerable to development of atrial 
      fibrillation but pathophysiology underlying this relation is only partly 
      understood. The aim of this study is to compare the severity and extensiveness of 
      conduction disorders between obese patients and nonobese patients measured at a 
      high-resolution scale. METHODS: Patients (N=212) undergoing cardiac surgery 
      (male:161, 63+/-11 years) underwent epicardial mapping of the right atrium, 
      Bachmann bundle, and left atrium during sinus rhythm. Conduction delay (CD) was 
      defined as interelectrode conduction time of 7 to 11 ms and conduction block (CB) 
      as conduction time >/=12 ms. Prevalence of CD/CB, continuous CDCB (cCDCB), length 
      of CD/CB/cCDCB lines, and severity of CB were analyzed. RESULTS: In obese 
      patients, the overall incidence of CD (3.1% versus 2.6%; P=0.002), CB (1.8% 
      versus 1.2%; P<0.001), and cCDCB (2.6% versus 1.9%; P<0.001) was higher and CD 
      (P=0.012) and cCDCB (P<0.001) lines are longer. There were more conduction 
      disorders at Bachmann bundle and this area has a higher incidence of CD (4.4% 
      versus 3.3%, P=0.002), CB (3.1% versus 1.6%, P<0.001), cCDCB (4.6% versus 2.7%, 
      P<0.001) and longer CD (P<0.001) or cCDCB (P=0.017) lines. The severity of CB is 
      also higher, particularly in the Bachmann bundle (P=0.008) and pulmonary vein 
      (P=0.020) areas. In addition, obese patients have a higher incidence of early 
      de-novo postoperative atrial fibrillation (P=0.003). Body mass index (P=0.037) 
      and the overall amount of CB (P=0.012) were independent predictors for incidence 
      of early postoperative atrial fibrillation. CONCLUSIONS: Compared with nonobese 
      patients, obese patients have higher incidences of conduction disorders, which 
      are also more extensive and more severe. These differences in heterogeneity in 
      conduction are already present during sinus rhythm and may explain the higher 
      vulnerability to atrial fibrillation of obese patients.
FAU - Schram-Serban, Corina
AU  - Schram-Serban C
AD  - Department of Cardiology (C.S.-S., A.H., M.C.R.-S., P.K., N.M.S.d.G.), Erasmus 
      University Medical Center, Rotterdam.
FAU - Heida, Annejet
AU  - Heida A
AD  - Department of Cardiology (C.S.-S., A.H., M.C.R.-S., P.K., N.M.S.d.G.), Erasmus 
      University Medical Center, Rotterdam.
FAU - Roos-Serote, Maarten C
AU  - Roos-Serote MC
AD  - Department of Cardiology (C.S.-S., A.H., M.C.R.-S., P.K., N.M.S.d.G.), Erasmus 
      University Medical Center, Rotterdam.
FAU - Knops, Paul
AU  - Knops P
AD  - Department of Cardiology (C.S.-S., A.H., M.C.R.-S., P.K., N.M.S.d.G.), Erasmus 
      University Medical Center, Rotterdam.
FAU - Kik, Charles
AU  - Kik C
AD  - Department of Cardio-Thoracic Surgery (C.K., A.J.J.C.B.), Erasmus University 
      Medical Center, Rotterdam.
FAU - Brundel, Bianca
AU  - Brundel B
AD  - Department of Physiology, Amsterdam UMC, Vrije Universiteit Amsterdam (B.B.).
AD  - Cardiovascular Sciences, Amsterdam, The Netherlands (B.B.).
FAU - Bogers, Ad J J C
AU  - Bogers AJJC
AD  - Department of Cardio-Thoracic Surgery (C.K., A.J.J.C.B.), Erasmus University 
      Medical Center, Rotterdam.
FAU - de Groot, Natasja M S
AU  - de Groot NMS
AD  - Department of Cardiology (C.S.-S., A.H., M.C.R.-S., P.K., N.M.S.d.G.), Erasmus 
      University Medical Center, Rotterdam.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20200417
PL  - United States
TA  - Circ Arrhythm Electrophysiol
JT  - Circulation. Arrhythmia and electrophysiology
JID - 101474365
SB  - IM
MH  - Action Potentials
MH  - Aged
MH  - Atrial Fibrillation/diagnosis/*epidemiology/physiopathology
MH  - Body Mass Index
MH  - Cardiac Surgical Procedures/*adverse effects
MH  - Case-Control Studies
MH  - Female
MH  - Heart Block/diagnosis/*epidemiology/physiopathology
MH  - Heart Conduction System/*physiopathology
MH  - *Heart Rate
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Obesity/diagnosis/*epidemiology/physiopathology
MH  - Prevalence
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Risk Factors
MH  - Severity of Illness Index
MH  - Time Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - atrial fibrillation
OT  - body mass index
OT  - cardiac electrophysiology
OT  - incidence
OT  - obesity
EDAT- 2020/04/18 06:00
MHDA- 2020/11/11 06:00
CRDT- 2020/04/18 06:00
PHST- 2020/04/18 06:00 [pubmed]
PHST- 2020/11/11 06:00 [medline]
PHST- 2020/04/18 06:00 [entrez]
AID - 10.1161/CIRCEP.119.008161 [doi]
PST - ppublish
SO  - Circ Arrhythm Electrophysiol. 2020 May;13(5):e008161. doi: 
      10.1161/CIRCEP.119.008161. Epub 2020 Apr 17.