David Gutierrez Blanco, MD, Mauricio Sarmiento Cobos, MD, David Romero Funes, MD, Lisandro Montorfano, MD, Emanuele Lo Menzo, MD, PhD, FACS, Rama Ganga, MD, Samuel Szomstein, MD, FACS, Raul J Rosenthal, MD, FACS. Cleveland Clinic Florida
INTRODUCTION: The relationship between obesity and atrial fibrillation (AF) has been previously established in the literature. Both conditions have been identified as major global epidemics associated with increased mortality and morbidity. Overweight populations have a higher incidence, prevalence, severity, and progression of AF. Furthermore, subjects with AF have markedly reduced survival compared with subjects without AF. Our goal in this study is to determine the impact of bariatric surgery on the risk of developing Atrial Fibrillation.
METHODS: We retrospectively reviewed all patients who underwent bariatric surgery at our institution from 2010 to 2015. Common demographics and comorbidities were collected, along with electrocardiograms readings preoperative and at 12 months follow-up. The risk was calculated based on previous criteria published by Schnabel RB, et al. All tests were two-tailed and performed at a significant level of 0.05. Statistical software R, version 3.3.1(2016-06-21) was used for all analyses.
RESULTS: Of the 1330 patients reviewed, 3.6% (n=48) patients met the criteria for inclusion; Females and Caucasians composed 54.2% (n=26) and 72.9% (n=35) of our population respectively. Diabetes was present in 68.8% and Hypertension in 66.7% of our patients. Laparoscopic Sleeve gastrectomy (50% n=24) and Laparoscopic Roux-en-Y gastric bypass (50% n=24) were the two types of surgeries done in our population. The risk of developing atrial fibrillation was calculated preoperatively and found a 7-fold higher risk in females and 4-fold greater risk in males when compared with the ideal risk for each category. At 12 months follow-up the preoperative risk was 11.14±15.45% with an absolute risk reduction of 2.03% corresponding to a relative risk reduction of 18.22% with males having a more significant change at 12 months follow-up. These findings and the electrocardiographic changes at 12 months follow-up are better described in table 1. The percentage of estimated BMI loss in our population was 51.1% at 12 months follow-up.
CONCLUSION: Patients undergoing bariatric surgery have a significantly higher risk of developing atrial fibrillation when compared to the ideal risk. Furthermore, bariatric surgery demonstrated to be effective in decreasing the risk of developing Atrial Fibrillation at 12 months follow-up particularly in males. Further studies may be needed to better assess these findings.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87058
Program Number: P636
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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