Division of Cardiology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Intern Med J. 2020 Jul;50(7):810-817. doi: 10.1111/imj.14436.
There are controversial data regarding the relationship between bariatric surgery and atrial fibrillation (AF). This meta-analysis was performed to evaluate (i) the incidence and (ii) the risk of AF in patients following bariatric surgery.
To explore the incidence and risk factors of AF in patients after bariatric surgery.
A literature search was conducted utilising MEDLINE, EMBASE and Cochrane Database from inception through March 2019. We included studies that evaluated the (i) incidence and (ii) risk of AF in patients after bariatric surgery. Pooled incidence and odds ratios (OR) with 95% confidence interval (CI) were calculated using random effects meta-analysis.
Seven cohort studies consisting of 7681 patients undergoing bariatric surgery were enrolled in this systematic review. The prevalence of AF in patients undergoing bariatric surgery ranged between 0% and 4.6%. Overall, the pooled estimated incidence of AF following bariatric surgery was 5.3% (95% CI: 1.9-13.8) at a median follow-up time of 7.9 years (interquartile range (IQR) 4.1-15.0 years). Compared to controls, the pooled OR of AF among patients undergoing bariatric surgery was 0.42 (95% CI: 0.22-0.83) at a median follow-up time of 7.9 years (IQR 7.2-19.0 years). Egger regression test demonstrated no significant publication bias in our meta-analysis of AF incidence following bariatric surgery.
The overall estimated incidence of AF following bariatric surgery was 5.3%. Our study demonstrates a significant beneficial association between bariatric surgery and AF, with a 0.42-fold decreased risk of AF. Future large-scale studies are needed to confirm the potential benefits of bariatric surgery on risk of AF.
关于减重手术与心房颤动（AF）之间的关系存在争议数据。进行这项荟萃分析是为了评估（i）减重手术后患者的 AF 发生率和（ii）AF 风险。
探讨减重手术后患者 AF 的发生率和危险因素。
通过 MEDLINE、EMBASE 和 Cochrane 数据库从成立到 2019 年 3 月进行文献检索。我们纳入了评估（i）减重手术后患者的 AF 发生率和（ii）AF 风险的研究。使用随机效应荟萃分析计算汇总发生率和比值比（OR）及其 95%置信区间（CI）。
本系统评价共纳入 7 项队列研究，共 7681 例患者接受减重手术。接受减重手术患者的 AF 患病率在 0%至 4.6%之间。总体而言，在中位随访时间为 7.9 年（四分位距（IQR）4.1-15.0 年）时，减重手术后 AF 的汇总估计发生率为 5.3%（95%CI：1.9-13.8）。与对照组相比，在中位随访时间为 7.9 年（IQR 7.2-19.0 年）时，接受减重手术的患者发生 AF 的汇总 OR 为 0.42（95%CI：0.22-0.83）。Egger 回归检验表明，我们对减重手术后 AF 发生率的荟萃分析中不存在显著的发表偏倚。
减重手术后 AF 的总体估计发生率为 5.3%。我们的研究表明，减重手术与 AF 之间存在显著的有益关联，AF 的风险降低了 0.42 倍。需要进行大规模的未来研究来证实减重手术对 AF 风险的潜在益处。
