Schram Serban Corina, de Groot Natasja M S
Department of Cardiology, Erasmus University Medical Center, 3015 GD Rotterdam, The Netherlands.
Department of Microelectronics, Circuits and Systems, Faculty of Electrical Engineering, Mathematics and Computer Sciences, Delft University of Technology, 2628 CD Delft, The Netherlands.
J Cardiovasc Dev Dis. 2023 Aug 8;10(8):342. doi: 10.3390/jcdd10080342.
(1) Background. Obesity is a well-established worldwide recognised risk factor for atrial fibrillation (AF). Prior review papers reported on the associations between obesity and AF development, but not on the relation between obesity and atrial electrophysiology. We therefore conducted a systematic review to describe the current knowledge of the characteristics of the atrial electrophysiological substrate in obese individuals and how they relate to the development of AF. (2) Methods. A search was conducted in Pubmed, Embase, and the Cochrane Library for publications evaluating the impact of obesity on atrial electrophysiology, electrical substrates, and their relation to the development of AF. (3) Results. A systematic literature search retrieved 477 potential publications based on the inclusion criteria; 76 full-text articles were selected for the present systematic review. The literature demonstrated that obesity predisposes to not only a higher AF incidence but also to more extensive atrial electrophysiological abnormalities increasing susceptibility to AF development. (4) Conclusion. Obesity may predispose to an overall increase in atrial electropathology, consisting of an increase in the slowing of the conduction, conduction block, low-voltage areas, and complex fractionated electrograms. To determine the impact of obesity-induced atrial electrical abnormalities on the long-term clinical outcome, further prospective studies are mandatory.
(1) 背景。肥胖是全球公认的心房颤动（AF）的危险因素。先前的综述文章报道了肥胖与房颤发生之间的关联，但未涉及肥胖与心房电生理学之间的关系。因此，我们进行了一项系统综述，以描述肥胖个体心房电生理基质特征的现有知识，以及它们与房颤发生的关系。(2) 方法。在PubMed、Embase和Cochrane图书馆中进行检索，以查找评估肥胖对心房电生理学、电基质及其与房颤发生关系影响的出版物。(3) 结果。基于纳入标准的系统文献检索共获得477篇潜在出版物；本系统综述选择了76篇全文文章。文献表明，肥胖不仅易导致较高的房颤发生率，还会导致更广泛的心房电生理异常，增加房颤发生的易感性。(4) 结论。肥胖可能会导致心房电病理总体增加，包括传导减慢、传导阻滞、低电压区域和复杂碎裂电图的增加。为了确定肥胖引起的心房电异常对长期临床结局的影响，进一步的前瞻性研究是必要的。
