Overweight and Obesity

Overweight and obesity are conditions characterized by excessive body fat resulting from long-term positive energy balance (energy intake exceeding energy expenditure). Both are associated with an increased risk of cardiovascular disease, type 2 diabetes mellitus, and other metabolic complications.

Adipose tissue surrounding the heart and atria promotes chronic inflammation, leading to fibrosis and atrial remodelling. This creates a substrate for atrial fibrillation (AF).

Illustration depicting overweight and obesity as significant risk factors for atrial fibrillation with an ECG recording of the arrhythmia.

Overweight and Obesity
Definition Overweight and obesity are conditions characterized by excessive body fat resulting from long-term positive energy balance (energy intake exceeding energy expenditure). Both are associated with an increased risk of cardiovascular disease, type 2 diabetes mellitus, and other metabolic complications.
Symptoms Dyspnoea Exercise intolerance Excessive sweating Fatigue Joint pain Snoring
Diagnosis Overweight or obesity is diagnosed using the formula: BMI = weight (kg) / height² (m²) Overweight: BMI >25 kg/m² Obesity: BMI >30 kg/m²

Weight reduction >10% or achieving BMI <27 kg/m² reduces the incidence, burden, and recurrence of AF.

After successful AF ablation, the risk of AF recurrence and other atrial arrhythmias increases by 13% with each 5 kg/m² increase in BMI.

Overweight, Obesity and Atrial Fibrillation	Class
BMI <27 kg/m² or weight reduction >10% in patients with overweight or obesity reduces the incidence and improves the clinical course of atrial fibrillation.	I
After successful atrial fibrillation (AF) ablation, the risk of AF recurrence and other atrial arrhythmias increases by 13% with each 5 kg/m² increase in BMI.	I
The target BMI in patients with atrial fibrillation is <27 kg/m².	I
In patients with BMI >40 kg/m², bariatric surgery should be considered.	IIb