What does this research mean for the field?

Obesity and nocturnal oxygen desaturation from obstructive sleep apnea independently predict incident atrial fibrillation in adults under 65 years of age. Novelty: ClaimNovelty.NOVEL_FINDING. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This study aims to determine if obesity and obstructive sleep apnea independently predict new-onset atrial fibrillation.

July 31, 2026Journal of the American College of CardiologyOpen Access

Obstructive Sleep Apnea, Obesity, and the Risk of Incident Atrial Fibrillation

Q: What are the key findings of this study?

In adults <65 years old, obesity (HR 1.07 per 1 kg/m2) and nocturnal oxygen desaturation (HR 3.29) independently predicted incident atrial fibrillation.

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Obstructive sleep apnea and obesity (n=3542). Intervention: Obstructive sleep apnea vs. Absence of obstructive sleep apnea. Primary outcome: Incident atrial fibrillation/flutter (HR 2.18, 95% CI 1.34-3.54).

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Key result

Nocturnal oxygen desaturation linked to ~229% greater AF risk in adults under 65, alongside obesity.

HR 2.18
95% CI 1.34-3.54
n=3,542

Why the study?

Obesity is a risk factor for AF and OSA is prevalent in obesity, but whether OSA independently predicts new-onset AF was unknown.

Population

3,542 Olmsted County adults without past or current AF referred for initial diagnostic polysomnogram

Comparison

Predictive value of obesity and OSA for incident AF

Design

Retrospective cohort study

Follow-up

Mean 4.7 years

Authors

AGApoor S. GamiElectrophysiology DHDave HodgeMayo Clinic RHRegina M. HergesMayo Clinic

Discussion

Member takes

Implication

Retrospective cohort study finds obesity and oxygen levels predict atrial fibrillation in adults under 65, indicating health risks.

Key Points

This study aims to determine if obesity and obstructive sleep apnea independently predict new-onset atrial fibrillation.
Retrospective cohort study of 3,542 Olmsted County adults without past atrial fibrillation.
Follow-up over a mean duration of 4.7 years with new-onset atrial fibrillation assessed via electrocardiography.
Evaluated predictors such as age, gender, obesity, and obstructive sleep apnea severity.
Incident atrial fibrillation occurred in 133 subjects (cumulative probability 14%, 95% CI 9% to 19%).
In individuals <65 years, independent predictors included OSA (HR 2.18, 95% CI 1.34 to 3.54) and nocturnal oxygen desaturation (HR 3.29, 95% CI 1.35 to 8.04).
In subjects ≥65 years, heart failure was a predictor, but obesity and OSA were not.

Study Design

Type

Cohort (n=3,542)

PICO

Population

3,542 adults without prior atrial fibrillation referred for an initial diagnostic polysomnogram, followed for a mean of 4.7 years.

Exposure / Comparator

Obstructive sleep apnea vs Absence of obstructive sleep apnea

Primary Outcome

Incident atrial fibrillation/flutter — HR 2.18 (1.34-3.54)

Main Result

Hazard Ratio: 2.18 (95% CI 1.34–3.54)

Cite This Study

Gami et al. (2007) conducted a cohort in Obstructive sleep apnea and obesity (n=3,542). Obstructive sleep apnea vs. Absence of obstructive sleep apnea was evaluated on Incident atrial fibrillation/flutter (HR 2.18, 95% CI 1.34-3.54). In adults <65 years old, obesity (HR 1.07 per 1 kg/m2) and nocturnal oxygen desaturation (HR 3.29) independently predicted incident atrial fibrillation.

synapsesocial.com/papers/6a6cbce6c767fbe144830ff0 https://doi.org/10.1016/j.jacc.2006.08.060

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Obstructive Sleep Apnea, Obesity, and the Risk of Incident Atrial Fibrillation

Discussion

Member takes

Implication

Key Points

Study Design

PICO

Main Result

Cite This Study

Obstructive Sleep Apnea, Obesity, and the Risk of Incident Atrial Fibrillation

Discussion

Member takes

Implication

Key Points

Study Design

PICO

Main Result

Cite This Study

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