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April 27, 2005

Obesity and the Risk of New-Onset Atrial Fibrillation

JAMA. 2005;293(16):1974-1975. doi:10.1001/jama.293.16.1974-a

To the Editor: The study by Dr Wang and colleagues1 provided evidence for an association between obesity and development of atrial fibrillation (AF). The authors proposed several underlying mechanisms but did not mention the potential role of inflammation in this setting. Accumulating evidence suggests that inflammation may have a significant impact on atrial remodeling, which favors perpetuation of AF.2 Even though it is not yet clear whether inflammation represents a cause or a consequence of AF, it has been recently demonstrated that elevated inflammatory indexes such as C-reactive protein indicate an increased risk for future development of AF.2,3 On the other hand, obesity has been clearly correlated with inflammation,4 whereas weight loss significantly reduces the levels of inflammatory indexes.5 It is therefore reasonable to assume that obesity-associated inflammation might contribute to the atrial remodeling. Whether this mechanism has a clinical impact on AF remains to be elucidated.

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