Despite an obesity paradox where overweight and obese patients with atrial fibrillation have a better prognosis than leaner patients, weight loss and physical activity provide prognostic benefits.
Does weight loss and physical activity improve prognosis in obese patients with atrial fibrillation despite the obesity paradox?
This review highlights that while an obesity paradox exists in atrial fibrillation, weight loss and exercise training still provide prognostic benefits for obese patients with AF.
Both obesity and atrial fibrillation (AF) are increasing in epidemic proportions, and both increase the prevalence of cardiovascular disease events. Obesity has adverse effects on cardiovascular hemodynamics and cardiac structure and function, and increases the prevalence of AF, partly related to electroanatomic remodeling in obese patients. However, numerous studies, including in AF, have demonstrated an obesity paradox, where overweight and obese patients with these disorders have a better prognosis than do leaner patients with the same degree of severity of cardiovascular disease/AF. In this paper, the authors discuss special issues regarding AF in obesity, as well as the evidence that despite the presence of an obesity paradox, there are benefits of weight loss, physical activity/exercise training, and increases in cardiorespiratory fitness on the prognosis of obese patients with AF.
Lavie et al. (Sun,) conducted a review in Obesity and Atrial Fibrillation. Weight loss and physical activity was evaluated. Despite an obesity paradox where overweight and obese patients with atrial fibrillation have a better prognosis than leaner patients, weight loss and physical activity provide prognostic benefits.
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