Obesity is one of the established risk factors of arterial fibrillation (AF). Antiarrhythmic drugs (AADs) are used to prevent and treat abnormal heartbeat conditions, like AF, but their effect on obesity-mediated AF is not clear. The objective of this study is to evaluate sodium channel blocker AADs in patients with obesity-mediated AF.

This observational cohort study included a total of 311 patients with confirmed symptomatic AF. Mice who were fed a high-fat diet for 10 weeks were also included. The patients were assigned to receive class 1 or 3 AADs. The primary objective was the symptomatic response to AAD, defined as a continuation of the same AAD for at least 3 months.

The findings suggested that non-response to class AADs was less in patients with obesity (30%) than in those without obesity (6%). Multivariable analysis indicated that obesity, AAD class, sex, and hyperthyroidism were the major indicators of non-response to AADs. In mice, pacing induced AF in 100% of diet-induced obesity mice, as compared with 30% in the controls.

The research concluded that obesity could significantly mediate the response to AADs in patients with symptomatic AF. The findings also suggested that obesity interferes differently in human patients and mice.

Ref: https://jamanetwork.com/journals/jamacardiology/article-abstract/2756247?resultClick=1