Obesity and Atrial Fibrillation

Atrial fibrillation is currently a central issue in the universe of cardiac arrhythmias. The increase in life expectancy that brought a substantial increase in its prevalence in the general population1 implied a marked deepening in the understanding of its electrophysiological mechanisms, in the identification of determining factors or potentiation of its occurrence and obviously in the development of effective strategies of treatment and prevention of its complications. Since the classic study of Wijffels et al., published in 1995 (Atrial Fibrillation Begets Atrial Fibrillation)2 which experimentally demonstrated that atrial frequencies artificially imposed to the atrial myocardium imply marked electrophysiological changes determining the very occurrence of atrial fibrillation, it became clear that once arrhythmia is initiated it potentiates its own occurrence and a constant process of feedback, whose final outcome over time is the installation of arrhythmia in a permanent form. However, for atrial fibrillation to occur, the presence of an adequate electrophysiological environment is necessary, consequent to the presence of several elements that aggress the atrial myocardium under the electrical and structural aspects.