• Ronpichai Chokesuwattanaskul, Charat Thongprayoon, Tarun Bathini, Konika Sharma, Kanramon Watthanasuntorn, Ploypin Lertjitbanjong, Pavida Pachariyanon, Somchai Prechawat, Michael A Mao, Aldo Torres-Ortiz, and Wisit Cheungpasitporn.
• Division of Cardiology, Department of Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
• Intern Med J. 2020 Jul 1; 50 (7): 810-817.

BackgroundThere are controversial data regarding the relationship between bariatric surgery and atrial fibrillation (AF). This meta-analysis was performed to evaluate (i) the incidence and (ii) the risk of AF in patients following bariatric surgery.AimsTo explore the incidence and risk factors of AF in patients after bariatric surgery.MethodsA literature search was conducted utilising MEDLINE, EMBASE and Cochrane Database from inception through March 2019. We included studies that evaluated the (i) incidence and (ii) risk of AF in patients after bariatric surgery. Pooled incidence and odds ratios (OR) with 95% confidence interval (CI) were calculated using random effects meta-analysis.ResultsSeven cohort studies consisting of 7681 patients undergoing bariatric surgery were enrolled in this systematic review. The prevalence of AF in patients undergoing bariatric surgery ranged between 0% and 4.6%. Overall, the pooled estimated incidence of AF following bariatric surgery was 5.3% (95% CI: 1.9-13.8) at a median follow-up time of 7.9 years (interquartile range (IQR) 4.1-15.0 years). Compared to controls, the pooled OR of AF among patients undergoing bariatric surgery was 0.42 (95% CI: 0.22-0.83) at a median follow-up time of 7.9 years (IQR 7.2-19.0 years). Egger regression test demonstrated no significant publication bias in our meta-analysis of AF incidence following bariatric surgery.ConclusionThe overall estimated incidence of AF following bariatric surgery was 5.3%. Our study demonstrates a significant beneficial association between bariatric surgery and AF, with a 0.42-fold decreased risk of AF. Future large-scale studies are needed to confirm the potential benefits of bariatric surgery on risk of AF.© 2019 Royal Australasian College of Physicians.

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