The Implications of Obesity for Cardiac Arrhythmia Mechanisms and Management

The ever-increasing prevalence of obesity poses a significant burden on the health care system with escalating socioeconomic consequences. At the individual level, obesity is well recognized to increase morbidity and mortality. Not only is obesity an established cardiovascular risk factor, it also increases the risk of sudden cardiac death and atrial fibrillation. Studies have shown that increased adiposity itself and the accompanying metabolic consequences of weight gain contribute to an abnormal arrhythmogenic substrate. In this review, we focus on the diverse mechanisms underlying cardiac arrhythmias related to obesity. In particular, we highlight the pathogenic role of adipose depots leading to increased atrial fibrillation and the effect of weight reduction in decreasing atrial fibrillation burden in obese individuals.