Electrophysiological and hemodynamic characteristics associated with obesity in patients with atrial fibrillation

Thomas M. Munger, Ying Xue Dong, Mitsuru Masaki, Jae K. Oh, Sunil V. Mankad, Barry A. Borlaug, Samuel J. Asirvatham, Win Kuang Shen, Hon Chi Lee, Suzette J. Bielinski, David O. Hodge, Regina M. Herges, Traci L. Buescher, Jia Hui Wu, Changsheng Ma, Yanhua Zhang, Peng Sheng Chen, Douglas L. Packer, Yong Mei Cha

Research output: Contribution to journalArticle

77 Citations (Scopus)

Abstract

The authors sought to characterize the left atrial (LA) and pulmonary vein (PV) electrophysiological and hemodynamic features in obese patients with atrial fibrillation (AF). Obesity is associated with increased risk for AF. A total of 63 consecutive patients with AF who had normal left ventricular (LV) ejection fraction and who underwent catheter ablation were studied. Atrial and PV electrophysiological studies were performed at the time of ablation with hemodynamic assessment by cardiac catheterization, and LA/LV structure and function by echocardiography. Patients were compared on the basis of body mass index (BMI): <25 kg/m 2 (n = 19) and BMI <30 kg/m 2 (n = 44). At a 600-ms pacing cycle length, obese patients had shorter effective refractory period (ERP) in the left atrium (251 ± 25 ms vs. 233 ± 32 ms, p = 0.04), and in the proximal (207 ± 33 ms vs. 248 ± 34 ms, p < 0.001) and distal (193 ± 33 ms vs. 248 ± 44 ms, p < 0.001) PV than normal BMI patients. Obese patients had higher mean LA pressure (15 ± 5 mm Hg vs. 10 ± 5 mm Hg, p < 0.001) and LA volume index (28 ± 12 ml/m 2 vs. 21 ± 14 ml/m 2, p = 0.006), and lower LA strain (5.5 ± 3.1% vs. 8.8 ± 2.8%; p < 0.001) than normal BMI patients. Increased LA pressure and volume, and shortened ERP in the left atrium and PV are potential factors facilitating and perpetuating AF in obese patients with AF.

Original languageEnglish (US)
Pages (from-to)851-860
Number of pages10
JournalJournal of the American College of Cardiology
Volume60
Issue number9
DOIs
StatePublished - Aug 28 2012

Fingerprint

Atrial Fibrillation
Obesity
Hemodynamics
Pulmonary Veins
Body Mass Index
Atrial Pressure
Heart Atria
Catheter Ablation
Cardiac Catheterization
Left Ventricular Function
Stroke Volume
Echocardiography

Keywords

  • atrial fibrillation
  • catheter ablation
  • electrophysiology
  • hemodynamics
  • obesity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Electrophysiological and hemodynamic characteristics associated with obesity in patients with atrial fibrillation. / Munger, Thomas M.; Dong, Ying Xue; Masaki, Mitsuru; Oh, Jae K.; Mankad, Sunil V.; Borlaug, Barry A.; Asirvatham, Samuel J.; Shen, Win Kuang; Lee, Hon Chi; Bielinski, Suzette J.; Hodge, David O.; Herges, Regina M.; Buescher, Traci L.; Wu, Jia Hui; Ma, Changsheng; Zhang, Yanhua; Chen, Peng Sheng; Packer, Douglas L.; Cha, Yong Mei.

In: Journal of the American College of Cardiology, Vol. 60, No. 9, 28.08.2012, p. 851-860.

Research output: Contribution to journalArticle

Munger, TM, Dong, YX, Masaki, M, Oh, JK, Mankad, SV, Borlaug, BA, Asirvatham, SJ, Shen, WK, Lee, HC, Bielinski, SJ, Hodge, DO, Herges, RM, Buescher, TL, Wu, JH, Ma, C, Zhang, Y, Chen, PS, Packer, DL & Cha, YM 2012, 'Electrophysiological and hemodynamic characteristics associated with obesity in patients with atrial fibrillation', Journal of the American College of Cardiology, vol. 60, no. 9, pp. 851-860. https://doi.org/10.1016/j.jacc.2012.03.042
Munger, Thomas M. ; Dong, Ying Xue ; Masaki, Mitsuru ; Oh, Jae K. ; Mankad, Sunil V. ; Borlaug, Barry A. ; Asirvatham, Samuel J. ; Shen, Win Kuang ; Lee, Hon Chi ; Bielinski, Suzette J. ; Hodge, David O. ; Herges, Regina M. ; Buescher, Traci L. ; Wu, Jia Hui ; Ma, Changsheng ; Zhang, Yanhua ; Chen, Peng Sheng ; Packer, Douglas L. ; Cha, Yong Mei. / Electrophysiological and hemodynamic characteristics associated with obesity in patients with atrial fibrillation. In: Journal of the American College of Cardiology. 2012 ; Vol. 60, No. 9. pp. 851-860.
@article{56dd25370a324e6cba3a9cea9eebc681,
title = "Electrophysiological and hemodynamic characteristics associated with obesity in patients with atrial fibrillation",
abstract = "The authors sought to characterize the left atrial (LA) and pulmonary vein (PV) electrophysiological and hemodynamic features in obese patients with atrial fibrillation (AF). Obesity is associated with increased risk for AF. A total of 63 consecutive patients with AF who had normal left ventricular (LV) ejection fraction and who underwent catheter ablation were studied. Atrial and PV electrophysiological studies were performed at the time of ablation with hemodynamic assessment by cardiac catheterization, and LA/LV structure and function by echocardiography. Patients were compared on the basis of body mass index (BMI): <25 kg/m 2 (n = 19) and BMI <30 kg/m 2 (n = 44). At a 600-ms pacing cycle length, obese patients had shorter effective refractory period (ERP) in the left atrium (251 ± 25 ms vs. 233 ± 32 ms, p = 0.04), and in the proximal (207 ± 33 ms vs. 248 ± 34 ms, p < 0.001) and distal (193 ± 33 ms vs. 248 ± 44 ms, p < 0.001) PV than normal BMI patients. Obese patients had higher mean LA pressure (15 ± 5 mm Hg vs. 10 ± 5 mm Hg, p < 0.001) and LA volume index (28 ± 12 ml/m 2 vs. 21 ± 14 ml/m 2, p = 0.006), and lower LA strain (5.5 ± 3.1{\%} vs. 8.8 ± 2.8{\%}; p < 0.001) than normal BMI patients. Increased LA pressure and volume, and shortened ERP in the left atrium and PV are potential factors facilitating and perpetuating AF in obese patients with AF.",
keywords = "atrial fibrillation, catheter ablation, electrophysiology, hemodynamics, obesity",
author = "Munger, {Thomas M.} and Dong, {Ying Xue} and Mitsuru Masaki and Oh, {Jae K.} and Mankad, {Sunil V.} and Borlaug, {Barry A.} and Asirvatham, {Samuel J.} and Shen, {Win Kuang} and Lee, {Hon Chi} and Bielinski, {Suzette J.} and Hodge, {David O.} and Herges, {Regina M.} and Buescher, {Traci L.} and Wu, {Jia Hui} and Changsheng Ma and Yanhua Zhang and Chen, {Peng Sheng} and Packer, {Douglas L.} and Cha, {Yong Mei}",
year = "2012",
month = "8",
day = "28",
doi = "10.1016/j.jacc.2012.03.042",
language = "English (US)",
volume = "60",
pages = "851--860",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "9",

}

TY - JOUR

T1 - Electrophysiological and hemodynamic characteristics associated with obesity in patients with atrial fibrillation

AU - Munger, Thomas M.

AU - Dong, Ying Xue

AU - Masaki, Mitsuru

AU - Oh, Jae K.

AU - Mankad, Sunil V.

AU - Borlaug, Barry A.

AU - Asirvatham, Samuel J.

AU - Shen, Win Kuang

AU - Lee, Hon Chi

AU - Bielinski, Suzette J.

AU - Hodge, David O.

AU - Herges, Regina M.

AU - Buescher, Traci L.

AU - Wu, Jia Hui

AU - Ma, Changsheng

AU - Zhang, Yanhua

AU - Chen, Peng Sheng

AU - Packer, Douglas L.

AU - Cha, Yong Mei

PY - 2012/8/28

Y1 - 2012/8/28

N2 - The authors sought to characterize the left atrial (LA) and pulmonary vein (PV) electrophysiological and hemodynamic features in obese patients with atrial fibrillation (AF). Obesity is associated with increased risk for AF. A total of 63 consecutive patients with AF who had normal left ventricular (LV) ejection fraction and who underwent catheter ablation were studied. Atrial and PV electrophysiological studies were performed at the time of ablation with hemodynamic assessment by cardiac catheterization, and LA/LV structure and function by echocardiography. Patients were compared on the basis of body mass index (BMI): <25 kg/m 2 (n = 19) and BMI <30 kg/m 2 (n = 44). At a 600-ms pacing cycle length, obese patients had shorter effective refractory period (ERP) in the left atrium (251 ± 25 ms vs. 233 ± 32 ms, p = 0.04), and in the proximal (207 ± 33 ms vs. 248 ± 34 ms, p < 0.001) and distal (193 ± 33 ms vs. 248 ± 44 ms, p < 0.001) PV than normal BMI patients. Obese patients had higher mean LA pressure (15 ± 5 mm Hg vs. 10 ± 5 mm Hg, p < 0.001) and LA volume index (28 ± 12 ml/m 2 vs. 21 ± 14 ml/m 2, p = 0.006), and lower LA strain (5.5 ± 3.1% vs. 8.8 ± 2.8%; p < 0.001) than normal BMI patients. Increased LA pressure and volume, and shortened ERP in the left atrium and PV are potential factors facilitating and perpetuating AF in obese patients with AF.

AB - The authors sought to characterize the left atrial (LA) and pulmonary vein (PV) electrophysiological and hemodynamic features in obese patients with atrial fibrillation (AF). Obesity is associated with increased risk for AF. A total of 63 consecutive patients with AF who had normal left ventricular (LV) ejection fraction and who underwent catheter ablation were studied. Atrial and PV electrophysiological studies were performed at the time of ablation with hemodynamic assessment by cardiac catheterization, and LA/LV structure and function by echocardiography. Patients were compared on the basis of body mass index (BMI): <25 kg/m 2 (n = 19) and BMI <30 kg/m 2 (n = 44). At a 600-ms pacing cycle length, obese patients had shorter effective refractory period (ERP) in the left atrium (251 ± 25 ms vs. 233 ± 32 ms, p = 0.04), and in the proximal (207 ± 33 ms vs. 248 ± 34 ms, p < 0.001) and distal (193 ± 33 ms vs. 248 ± 44 ms, p < 0.001) PV than normal BMI patients. Obese patients had higher mean LA pressure (15 ± 5 mm Hg vs. 10 ± 5 mm Hg, p < 0.001) and LA volume index (28 ± 12 ml/m 2 vs. 21 ± 14 ml/m 2, p = 0.006), and lower LA strain (5.5 ± 3.1% vs. 8.8 ± 2.8%; p < 0.001) than normal BMI patients. Increased LA pressure and volume, and shortened ERP in the left atrium and PV are potential factors facilitating and perpetuating AF in obese patients with AF.

KW - atrial fibrillation

KW - catheter ablation

KW - electrophysiology

KW - hemodynamics

KW - obesity

UR - http://www.scopus.com/inward/record.url?scp=84865290643&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84865290643&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2012.03.042

DO - 10.1016/j.jacc.2012.03.042

M3 - Article

C2 - 22726633

AN - SCOPUS:84865290643

VL - 60

SP - 851

EP - 860

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 9

ER -