Bariatric surgery partially reverses subclinical proarrhythmic structural, electrophysiological, and autonomic changes in obesity
Authors' conclusion
Obesity is associated with adverse electrophysiological, structural, and autonomic remodeling that is partially reversed after bariatric surgery.
Study context
- Population
- Arrhythmia-free obese patients undergoing bariatric surgery12 (75%) had post-surgery electrocardiographic imaging (ECGi)
- Participants
- 16 / 12 / 16
- Exposure
- Obese patients before vs after bariatric surgery; obese vs lean controls
- Obese pre-surgeryn = 16reference
- Obese post-surgeryn = 12
- Lean controlsn = 16
- Outcome
- Reverse remodelling after bariatric surgery (pre- vs postsurgery)
Methodological detailsage- and sex-matched controls, ECGi before and after surgery, computational modelling
- Age- and sex-matched controls
- ECGi before and after surgery
- Computational modelling
Main finding
As reported in the abstract
- Atrial activation remained prolonged after surgery
- Obesity vs lean controls: increased epicardial fat and LV mass, blunted HRV, slower atrial conduction, steeper ventricular repolarization time gradients
- Postsurgery vs Presurgery: P = 0.0010
- Postsurgery vs Presurgery: P < 0.0005
- Postsurgery vs Presurgery: P = 0.0009
- Postsurgery vs Presurgery: P = 0.017
- 12 of 16 had postsurgery ECGi
Observational data: associations, not effects.
Further findings
Obesity vs lean controls
- Obesity associated with increased epicardial fat and LV mass, blunted HRV, slower atrial conduction and steeper ventricular repolarization time gradients
Computational modelling
- Presurgical obese hearts: larger window of vulnerability to unidirectional block, earlier spiral-wave breakup, more complex reentry than postsurgery
Original publication
Bariatric surgery partially reverses subclinical proarrhythmic structural, electrophysiological, and autonomic changes in obesity. Heart Rhythm. Published 31 May 2024. doi:10.
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