Electrophysiological and hemodynamic characteristics associated with obesity in patients with atrial fibrillation

Thomas M. Munger, Ying Xue Dong, Mitsuru Masaki, Jae K. Oh, Sunil V. Mankad, Barry A. Borlaug, Samuel J. Asirvatham, Win Kuang Shen, Hon Chi Lee, Suzette J. Bielinski, David O. Hodge, Regina M. Herges, Traci L. Buescher, Jia Hui Wu, Changsheng Ma, Yanhua Zhang, Peng Sheng Chen, Douglas L. Packer, Yong Mei Cha

Research output: Contribution to journalArticlepeer-review

93 Scopus citations


The authors sought to characterize the left atrial (LA) and pulmonary vein (PV) electrophysiological and hemodynamic features in obese patients with atrial fibrillation (AF). Obesity is associated with increased risk for AF. A total of 63 consecutive patients with AF who had normal left ventricular (LV) ejection fraction and who underwent catheter ablation were studied. Atrial and PV electrophysiological studies were performed at the time of ablation with hemodynamic assessment by cardiac catheterization, and LA/LV structure and function by echocardiography. Patients were compared on the basis of body mass index (BMI): <25 kg/m 2 (n = 19) and BMI <30 kg/m 2 (n = 44). At a 600-ms pacing cycle length, obese patients had shorter effective refractory period (ERP) in the left atrium (251 ± 25 ms vs. 233 ± 32 ms, p = 0.04), and in the proximal (207 ± 33 ms vs. 248 ± 34 ms, p < 0.001) and distal (193 ± 33 ms vs. 248 ± 44 ms, p < 0.001) PV than normal BMI patients. Obese patients had higher mean LA pressure (15 ± 5 mm Hg vs. 10 ± 5 mm Hg, p < 0.001) and LA volume index (28 ± 12 ml/m 2 vs. 21 ± 14 ml/m 2, p = 0.006), and lower LA strain (5.5 ± 3.1% vs. 8.8 ± 2.8%; p < 0.001) than normal BMI patients. Increased LA pressure and volume, and shortened ERP in the left atrium and PV are potential factors facilitating and perpetuating AF in obese patients with AF.

Original languageEnglish (US)
Pages (from-to)851-860
Number of pages10
JournalJournal of the American College of Cardiology
Issue number9
StatePublished - Aug 28 2012


  • atrial fibrillation
  • catheter ablation
  • electrophysiology
  • hemodynamics
  • obesity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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