Year 2018, Volume 21, Issue 3, Pages 230 - 235 2018-12-02

Artmış Vücut Kitle İndeksi Cihaz ile Saptanan Sessiz Atriyal Fibrilasyon Atakları ile İlişkilidir
Increased Body Mass Index is Associated with Device Detected Silent Atrial Fibrillation

Emrah Bozbeyoğlu [1] , Göksel Çinier [2]

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Giriş: Atriyal fibrilasyon (AF) klinikte en sık karşılaşılan ritm bozukluğudur. AF ile ilişkili modifiye edilebilen risk faktörlerinin tedavi edilmesi AF’ye bağlı iskemik inme gibi katastrofik sonuçları engelleyebilmektedir. Artmış vücut kitle indeksi (VKİ) semptomatik AF atakları ile ilişkilendirilmiştir. Ancak VKİ ile asemptomatik AF arasındaki ilişki henüz ortaya çıkarılmamıştır.

Hastalar ve Yöntem: Daha önce çift odacıklı pacemaker takılmış 449 hasta çalışmaya dahil edilmiştir. Hastalar VKİ değerlerine göre üç gruba ayrılmıştır (normal VKİ: VKİ 18-25 kg/m2, kilolu: VKİ 25-30 kg/m2 ve obez: VKİ > 30 kg/m2). Cihaz implantasyonundan 6 ay sonra yapılan kontrolde sessiz AF atakları yerine geçen atriyal yüksek hız epizodları (AYHE) tarandı. AYHE 5 dakikadan uzun ve 220/dakika’dan uzun epizodlar olarak tanımlandı.

Bulgular: Cihaz kontrolleri sonunda hastaların 128 (28.5%)’inde AYHE saptandı. AYHE (+) hastalar AYHE (-) hastalara göre daha yaşlı (65.51 ± 8.99 vs. 70.84 ± 8.05 p< 0.01) ve daha yüksek VKİ’ye (26.84 ± 3.41 kg/mvs. 28.65 ± 3.75 kg/m2 p< 0.01) sahip bulundu. AYHE (+) hastaların istirahat kalp hızları (84.03 ± 7.80 vs. 74.76 ± 6.40 vs. p< 0.01), sol atriyum antero-posterior çapları (LA-AP) (4.14 ± 0.33 vs. 3.90 ± 0.31, p< 0.01), sol atriyum volümleri (LAV) (31.92 ± 3.17 vs. 30.38 ± 3.15, p< 0.01) ve CHA2DS2-VASc skorları (2.29 ± 0.83 vs. 1.81 ± 0.76, p< 0.01) AYHE (-) hastalara göre daha yüksek bulundu. Yapılan çok değişkenli analizde artmış VKİ, istirahat kalp hızı, LA-AP ve CHA2DS2-VASc skorunun bağımsız olarak AYHE prediktörleri olduğu gösterildi.

Sonuç: Artmış VKİ sadece semptomatik AF ile değil aynı zamanda cihaz tarafından saptanan sessiz AF epizodları ile ilişkilidir.

Introduction: Atrial fibrillation (AF) is the most common cardiac rhythm disturbance in clinical practice. To prevent adverse outcomes associated with AF, it is necessary to identify and manage the modifiable risk factors. An increased body mass index (BMI) is strongly associated with the incidence of clinically symptomatic AF. However, the association of increased BMI with asymptomatic AF is unknown.

Patients and Methods: We prospectively evaluated 449 patients implanted with dual chamber pacemaker. Patients were divided into 3 groups according to their baseline BMI (normal weight: BMI 18-25 kg/m2, overweight: BMI 25-30 kg/m2, and obesity: BMI > 30 kg/m2). Six months after the device implantation, pacemakers were interrogated to identify atrial high rate episodes (AHREs), which were defined as episodes faster than 220 bpm and longer than 5 minutes.

Results: AHRE was detected in 128 (28.5%) patients. Patients in the AHRE (+) group were older (65.51 ± 8.99 years vs. 70.84 ± 8.05 years, p< 0.01) and had greater BMI (26.84 ± 3.41 kg/m2 vs. 28.65 ± 3.75 kg/m2, p< 0.01) compared to those in the AHRE (-) group. Patients in the AHRE (+) group had significantly higher mean resting heart rate (84.03 ± 7.80 bpm vs. 74.76 ± 6.40 bpm, p< 0.01), greater left atrium antero-posterior (LA-AP) diameter (4.14 ± 0.33 cm vs. 3.90 ± 0.31 cm, p< 0.01), left atrium volume (31.92 ± 3.17 vs. 30.38 ± 3.15, p< 0.01), and CHA2DS2-VASc score (2.29 ± 0.83 vs. 1.81 ± 0.76, p< 0.01). On multivariate analysis, increased BMI, age, mean resting heart rate, LA-AP diameter, and CHA2DS2-VASc score were independently associated with the incidence of AHRE.

Conclusion: Increased BMI is not only associated with symptomatic AF but also with asymptomatic AF detected by cardiac implantable electronic devices.
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Primary Language en
Subjects Medicine
Journal Section Original Investigations
Authors

Author: Emrah Bozbeyoğlu

Author: Göksel Çinier (Primary Author)

Bibtex @research article { khj495091, journal = {Koşuyolu Heart Journal}, issn = {2149-2972}, eissn = {2149-2980}, address = {Kartal Koşuyolu Yüksek İhtisas EAH}, year = {2018}, volume = {21}, pages = {230 - 235}, doi = {}, title = {Increased Body Mass Index is Associated with Device Detected Silent Atrial Fibrillation}, key = {cite}, author = {Bozbeyoğlu, Emrah and Çinier, Göksel} }
APA Bozbeyoğlu, E , Çinier, G . (2018). Increased Body Mass Index is Associated with Device Detected Silent Atrial Fibrillation. Koşuyolu Heart Journal, 21 (3), 230-235. Retrieved from http://dergipark.org.tr/khj/issue/40963/495091
MLA Bozbeyoğlu, E , Çinier, G . "Increased Body Mass Index is Associated with Device Detected Silent Atrial Fibrillation". Koşuyolu Heart Journal 21 (2018): 230-235 <http://dergipark.org.tr/khj/issue/40963/495091>
Chicago Bozbeyoğlu, E , Çinier, G . "Increased Body Mass Index is Associated with Device Detected Silent Atrial Fibrillation". Koşuyolu Heart Journal 21 (2018): 230-235
RIS TY - JOUR T1 - Increased Body Mass Index is Associated with Device Detected Silent Atrial Fibrillation AU - Emrah Bozbeyoğlu , Göksel Çinier Y1 - 2018 PY - 2018 N1 - DO - T2 - Koşuyolu Heart Journal JF - Journal JO - JOR SP - 230 EP - 235 VL - 21 IS - 3 SN - 2149-2972-2149-2980 M3 - UR - Y2 - 2019 ER -
EndNote %0 Koşuyolu Heart Journal Increased Body Mass Index is Associated with Device Detected Silent Atrial Fibrillation %A Emrah Bozbeyoğlu , Göksel Çinier %T Increased Body Mass Index is Associated with Device Detected Silent Atrial Fibrillation %D 2018 %J Koşuyolu Heart Journal %P 2149-2972-2149-2980 %V 21 %N 3 %R %U
ISNAD Bozbeyoğlu, Emrah , Çinier, Göksel . "Increased Body Mass Index is Associated with Device Detected Silent Atrial Fibrillation". Koşuyolu Heart Journal 21 / 3 (December 2018): 230-235.