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Impact of Nonalcoholic Fatty Liver Disease on Arrhythmia Recurrence Following Atrial Fibrillation Ablation
This study sought to investigate the association between nonalcoholic fatty liver disease (NAFLD) and arrhythmia recurrence following atrial fibrillation ablation; and to examine the impact of NAFLD stage on outcomes. Metabolic derangements, including obesity and diabetes, are associated with incide...
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Published in: | JACC. Clinical electrophysiology 2020-10, Vol.6 (10), p.1278-1287 |
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container_title | JACC. Clinical electrophysiology |
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creator | Donnellan, Eoin Cotter, Thomas G. Wazni, Oussama M. Elshazly, Mohamed B. Kochar, Arshneel Wilner, Bryan Patel, Divyang Kanj, Mohamed Hussein, Ayman Baranowski, Bryan Cantillon, Daniel Griffin, Brian Jaber, Wael Saliba, Walid I. |
description | This study sought to investigate the association between nonalcoholic fatty liver disease (NAFLD) and arrhythmia recurrence following atrial fibrillation ablation; and to examine the impact of NAFLD stage on outcomes.
Metabolic derangements, including obesity and diabetes, are associated with incident and recurrent atrial fibrillation (AF), in addition to the development of NAFLD.
This was a retrospective study of 267 consecutive patients undergoing AF ablation, 89 of whom were diagnosed with NAFLD prior to ablation and matched in a 2:1 manner based on age, sex, body mass index, ejection fraction, and AF type with 178 patients without NAFLD. Patients were monitored for arrhythmia recurrence during a mean follow-up of 29 months.
Recurrent arrhythmia was observed in 50 (56%) patients with NAFLD compared with 37 (21%) without NAFLD. Epicardial fat volume was measured on computed tomography and was significantly higher among those with NAFLD (248 ± 125 ml vs. 223 ± 97 ml; p = 0.01). On multivariable models adjusting for sleep apnea, body mass index, heart failure, AF type, and left atrial size, NAFLD was independently associated with increased rates of arrhythmia recurrence (hazard ratio: 3.010; 95% confidence interval: 1.980 to 4.680; p |
doi_str_mv | 10.1016/j.jacep.2020.05.023 |
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Metabolic derangements, including obesity and diabetes, are associated with incident and recurrent atrial fibrillation (AF), in addition to the development of NAFLD.
This was a retrospective study of 267 consecutive patients undergoing AF ablation, 89 of whom were diagnosed with NAFLD prior to ablation and matched in a 2:1 manner based on age, sex, body mass index, ejection fraction, and AF type with 178 patients without NAFLD. Patients were monitored for arrhythmia recurrence during a mean follow-up of 29 months.
Recurrent arrhythmia was observed in 50 (56%) patients with NAFLD compared with 37 (21%) without NAFLD. Epicardial fat volume was measured on computed tomography and was significantly higher among those with NAFLD (248 ± 125 ml vs. 223 ± 97 ml; p = 0.01). On multivariable models adjusting for sleep apnea, body mass index, heart failure, AF type, and left atrial size, NAFLD was independently associated with increased rates of arrhythmia recurrence (hazard ratio: 3.010; 95% confidence interval: 1.980 to 4.680; p < 0.0001).
NAFLD is associated with significantly increased arrhythmia recurrence rates following AF ablation. Identification and reversal, where possible, may result in improved arrhythmia-free survival.
[Display omitted]</description><identifier>ISSN: 2405-500X</identifier><identifier>EISSN: 2405-5018</identifier><identifier>DOI: 10.1016/j.jacep.2020.05.023</identifier><identifier>PMID: 33092755</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>atrial fibrillation ablation ; diabetes ; nonalcoholic fatty liver disease ; obesity ; risk factor modification</subject><ispartof>JACC. Clinical electrophysiology, 2020-10, Vol.6 (10), p.1278-1287</ispartof><rights>2020 American College of Cardiology Foundation</rights><rights>Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c404t-cd18df74da2c10ede9198f84ecf517700eb01e9829fc35787758e95fc86ebd063</citedby><cites>FETCH-LOGICAL-c404t-cd18df74da2c10ede9198f84ecf517700eb01e9829fc35787758e95fc86ebd063</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S2405500X20304606$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3549,27924,27925,45780</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33092755$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Donnellan, Eoin</creatorcontrib><creatorcontrib>Cotter, Thomas G.</creatorcontrib><creatorcontrib>Wazni, Oussama M.</creatorcontrib><creatorcontrib>Elshazly, Mohamed B.</creatorcontrib><creatorcontrib>Kochar, Arshneel</creatorcontrib><creatorcontrib>Wilner, Bryan</creatorcontrib><creatorcontrib>Patel, Divyang</creatorcontrib><creatorcontrib>Kanj, Mohamed</creatorcontrib><creatorcontrib>Hussein, Ayman</creatorcontrib><creatorcontrib>Baranowski, Bryan</creatorcontrib><creatorcontrib>Cantillon, Daniel</creatorcontrib><creatorcontrib>Griffin, Brian</creatorcontrib><creatorcontrib>Jaber, Wael</creatorcontrib><creatorcontrib>Saliba, Walid I.</creatorcontrib><title>Impact of Nonalcoholic Fatty Liver Disease on Arrhythmia Recurrence Following Atrial Fibrillation Ablation</title><title>JACC. Clinical electrophysiology</title><addtitle>JACC Clin Electrophysiol</addtitle><description>This study sought to investigate the association between nonalcoholic fatty liver disease (NAFLD) and arrhythmia recurrence following atrial fibrillation ablation; and to examine the impact of NAFLD stage on outcomes.
Metabolic derangements, including obesity and diabetes, are associated with incident and recurrent atrial fibrillation (AF), in addition to the development of NAFLD.
This was a retrospective study of 267 consecutive patients undergoing AF ablation, 89 of whom were diagnosed with NAFLD prior to ablation and matched in a 2:1 manner based on age, sex, body mass index, ejection fraction, and AF type with 178 patients without NAFLD. Patients were monitored for arrhythmia recurrence during a mean follow-up of 29 months.
Recurrent arrhythmia was observed in 50 (56%) patients with NAFLD compared with 37 (21%) without NAFLD. Epicardial fat volume was measured on computed tomography and was significantly higher among those with NAFLD (248 ± 125 ml vs. 223 ± 97 ml; p = 0.01). On multivariable models adjusting for sleep apnea, body mass index, heart failure, AF type, and left atrial size, NAFLD was independently associated with increased rates of arrhythmia recurrence (hazard ratio: 3.010; 95% confidence interval: 1.980 to 4.680; p < 0.0001).
NAFLD is associated with significantly increased arrhythmia recurrence rates following AF ablation. Identification and reversal, where possible, may result in improved arrhythmia-free survival.
[Display omitted]</description><subject>atrial fibrillation ablation</subject><subject>diabetes</subject><subject>nonalcoholic fatty liver disease</subject><subject>obesity</subject><subject>risk factor modification</subject><issn>2405-500X</issn><issn>2405-5018</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kE1LxDAQhoMoKuovECRHL1snabNNDx4WdVVYFETBW0jTqZvSNmuSVfbf27rq0dPM4Xnn4yHklEHCgE0vmqTRBlcJBw4JiAR4ukMOeQZiIoDJ3b8eXg_ISQgNADDBJWfZPjlIUyh4LsQhae67lTaRupo-uF63xi1daw2d6xg3dGE_0NNrG1AHpK6nM--Xm7jsrKZPaNbeY2-Qzl3buk_bv9FZ9Fa3dG5Lb9tWRztmym1zTPZq3QY8-alH5GV-83x1N1k83t5fzRYTk0EWJ6ZisqrzrNLcMMAKC1bIWmZoasHyHABLYFhIXtQmFbnMcyGxELWRUywrmKZH5Hw7d-Xd-xpDVJ0NBodzenTroHgmstHhFAY03aLGuxA81mrlbaf9RjFQI6Ma9e1ZjZ4VCDV4HlJnPwvWZYfVX-bX6gBcbgEc3vyw6FUwdjRVWY8mqsrZfxd8AdNIkCk</recordid><startdate>202010</startdate><enddate>202010</enddate><creator>Donnellan, Eoin</creator><creator>Cotter, Thomas G.</creator><creator>Wazni, Oussama M.</creator><creator>Elshazly, Mohamed B.</creator><creator>Kochar, Arshneel</creator><creator>Wilner, Bryan</creator><creator>Patel, Divyang</creator><creator>Kanj, Mohamed</creator><creator>Hussein, Ayman</creator><creator>Baranowski, Bryan</creator><creator>Cantillon, Daniel</creator><creator>Griffin, Brian</creator><creator>Jaber, Wael</creator><creator>Saliba, Walid I.</creator><general>Elsevier Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>202010</creationdate><title>Impact of Nonalcoholic Fatty Liver Disease on Arrhythmia Recurrence Following Atrial Fibrillation Ablation</title><author>Donnellan, Eoin ; Cotter, Thomas G. ; Wazni, Oussama M. ; Elshazly, Mohamed B. ; Kochar, Arshneel ; Wilner, Bryan ; Patel, Divyang ; Kanj, Mohamed ; Hussein, Ayman ; Baranowski, Bryan ; Cantillon, Daniel ; Griffin, Brian ; Jaber, Wael ; Saliba, Walid I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c404t-cd18df74da2c10ede9198f84ecf517700eb01e9829fc35787758e95fc86ebd063</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>atrial fibrillation ablation</topic><topic>diabetes</topic><topic>nonalcoholic fatty liver disease</topic><topic>obesity</topic><topic>risk factor modification</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Donnellan, Eoin</creatorcontrib><creatorcontrib>Cotter, Thomas G.</creatorcontrib><creatorcontrib>Wazni, Oussama M.</creatorcontrib><creatorcontrib>Elshazly, Mohamed B.</creatorcontrib><creatorcontrib>Kochar, Arshneel</creatorcontrib><creatorcontrib>Wilner, Bryan</creatorcontrib><creatorcontrib>Patel, Divyang</creatorcontrib><creatorcontrib>Kanj, Mohamed</creatorcontrib><creatorcontrib>Hussein, Ayman</creatorcontrib><creatorcontrib>Baranowski, Bryan</creatorcontrib><creatorcontrib>Cantillon, Daniel</creatorcontrib><creatorcontrib>Griffin, Brian</creatorcontrib><creatorcontrib>Jaber, Wael</creatorcontrib><creatorcontrib>Saliba, Walid I.</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>JACC. Clinical electrophysiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Donnellan, Eoin</au><au>Cotter, Thomas G.</au><au>Wazni, Oussama M.</au><au>Elshazly, Mohamed B.</au><au>Kochar, Arshneel</au><au>Wilner, Bryan</au><au>Patel, Divyang</au><au>Kanj, Mohamed</au><au>Hussein, Ayman</au><au>Baranowski, Bryan</au><au>Cantillon, Daniel</au><au>Griffin, Brian</au><au>Jaber, Wael</au><au>Saliba, Walid I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of Nonalcoholic Fatty Liver Disease on Arrhythmia Recurrence Following Atrial Fibrillation Ablation</atitle><jtitle>JACC. Clinical electrophysiology</jtitle><addtitle>JACC Clin Electrophysiol</addtitle><date>2020-10</date><risdate>2020</risdate><volume>6</volume><issue>10</issue><spage>1278</spage><epage>1287</epage><pages>1278-1287</pages><issn>2405-500X</issn><eissn>2405-5018</eissn><abstract>This study sought to investigate the association between nonalcoholic fatty liver disease (NAFLD) and arrhythmia recurrence following atrial fibrillation ablation; and to examine the impact of NAFLD stage on outcomes.
Metabolic derangements, including obesity and diabetes, are associated with incident and recurrent atrial fibrillation (AF), in addition to the development of NAFLD.
This was a retrospective study of 267 consecutive patients undergoing AF ablation, 89 of whom were diagnosed with NAFLD prior to ablation and matched in a 2:1 manner based on age, sex, body mass index, ejection fraction, and AF type with 178 patients without NAFLD. Patients were monitored for arrhythmia recurrence during a mean follow-up of 29 months.
Recurrent arrhythmia was observed in 50 (56%) patients with NAFLD compared with 37 (21%) without NAFLD. Epicardial fat volume was measured on computed tomography and was significantly higher among those with NAFLD (248 ± 125 ml vs. 223 ± 97 ml; p = 0.01). On multivariable models adjusting for sleep apnea, body mass index, heart failure, AF type, and left atrial size, NAFLD was independently associated with increased rates of arrhythmia recurrence (hazard ratio: 3.010; 95% confidence interval: 1.980 to 4.680; p < 0.0001).
NAFLD is associated with significantly increased arrhythmia recurrence rates following AF ablation. Identification and reversal, where possible, may result in improved arrhythmia-free survival.
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subjects | atrial fibrillation ablation diabetes nonalcoholic fatty liver disease obesity risk factor modification |
title | Impact of Nonalcoholic Fatty Liver Disease on Arrhythmia Recurrence Following Atrial Fibrillation Ablation |
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