Introduction: Obesity and overweight are strongly associated with cardiovascular morbidity and mortality. However, there are limited data regarding the association between excess weight and the risk for the development of cardiac arrhythmias.
Methods: We investigated the association between body mass index (BMI) and atrial and ventricular arrhythmias during exercise stress testing (EST) among 23,343 apparently healthy men and women who attended periodic health screening examinations between the years 2000-2014. All subjects completed maximal EST according to the Bruce protocol and had their BMI documented annually. Subjects were divided at baseline into three groups: normal weight (BMI≥18.5 and <25; N=9,842), overweight (BMI≥25 and <30; N=10,247) and obese (BMI≥30 Kg/m2; N=3254).
Results: The mean age of study subjects was 48 ± 11 years and 73% were man. A total of 2,294 arrhythmic events occurred during at least one of 3 consecutive tests. Kaplan Meier survival analysis showed that the cumulative probability of ventricular arrhythmias was highest among obese subjects, intermediate among overweight subjects and lowest among subjects with normal weight (38.4%, 34.1% and 29.1% respectively; p<0.001). Multivariate binary logistic regression with repeated measures showed that obese subjects were 20% more likely to have ventricular arrhythmias during exercise compared with subjects with normal weight (p=0.005).
Conclusion: Obesity is independently associated with increased likelihood of both atrial and ventricular arrhythmia during exercise.
