61b2752099673222c324a04092261b1d 306962.pdf 221360aa2cef4a8ecf2f989b1a8dbc8d892b7e88 306962.pdf fc38d7a5475834fb6218b3dd8728d704737d35a6ec6bdb7a3540bf217d9e9d8c 306962.pdf Title: Impact of Body Mass Index in the Cardioverter Efficacy of Amiodarone in Persistent Atrial Fibrillation Subject: Background: Amiodarone is an anti-arrhythmic drug that has extensive tissue distribution and substantial storage in the fat tissue. Different studies have described some implications of body fat composition in its pharmacokinetics and pharmacodynamics. However, no clinical studies have described its implications for clinical efficacy. Methods: We studied 878 patients with persistent atrial fibrillation (AF) treated with a regimen of amiodarone and referred to electrical cardioversion (ECV), included prospectively in two Spanish registries. We analyzed the influence of body mass index (BMI), as well as overweight and obesity, in the efficacy of amiodarone for achieving pharmacologic cardioversion to sinus rhythm (SR) before ECV. Results: A total of 185 patients (21.1%) reverted to SR before ECV. Patients who reverted to SR had a lower BMI than those who did not revert (27.45 4.36 kg/m2 vs. 29.11 4.09 kg/m2; p < 0.001). We observed a progressively lower probability of reverting to SR in overweight and obese patients (normal weight 28.3%, overweight 21.3%, obesity 13.1%; p < 0.001). In the logistic regression, BMI (kg/m2) adjusted for other related variables remained as the main factor inversely related to reversion to SR (OR = 0.904 kg/m2); CI 75% 0.864–0.946). Conclusions: We observed a negative relationship between an increased BMI and the efficacy of amiodarone for reversion to SR, suggesting a negative clinical impact of excess body fat in its efficacy. Keywords: atrial fibrillation; amiodarone; body mass index; pharmacological cardioversion; sinus rhythm Author: Carmen Ligero, Pau Riera, Amine El-Amrani, Victor Bazan, José M. Guerra, Silvia Herraez, Xavier Viñolas and Josep M. Alegret Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Tue May 28 08:41:45 2024 CEST ModDate: Tue May 28 08:45:50 2024 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 9 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 1064317 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- BTFGED+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 BFTDWW+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 JLHNHG+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 YIIZXQ+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 VSPIKV+CMSY10 Type 1 Builtin yes yes yes 32 0 ECICOX+VnURWPalladioL Type 1 Custom yes yes yes 37 0 VWRBXB+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 53 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes yes 70 0 CIDFont+F3 CID TrueType Identity-H yes no yes 80 0 CIDFont+F1 CID TrueType Identity-H yes no yes 88 0 CIDFont+F2 CID TrueType Identity-H yes no yes 96 0 CIDFont+F5 CID TrueType Identity-H yes no yes 104 0 CIDFont+F3 CID TrueType Identity-H yes no yes 115 0 CIDFont+F1 CID TrueType Identity-H yes no yes 123 0 CIDFont+F2 CID TrueType Identity-H yes no yes 131 0 CIDFont+F6 CID TrueType Identity-H yes no yes 139 0 CIDFont+F5 CID TrueType Identity-H yes no yes 147 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-02-07 02:47:21 CET RepresentationInformation: 306962.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-02-06 19:41:08 CET Size: 1064317 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 308 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Results Destination: section.2 Children: Item: Title: Patients’ Characteristics Destination: subsection.2.1 Item: Title: BMI and SR Reversion Destination: subsection.2.2 Item: Title: Discussion Destination: section.3 Item: Title: Materials and Methods Destination: section.4 Children: Item: Title: Study Population Destination: subsection.4.1 Item: Title: Statistical Analysis Destination: subsection.4.2 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: appendix.A. Info: Title: Impact of Body Mass Index in the Cardioverter Efficacy of Amiodarone in Persistent Atrial Fibrillation Author: Carmen Ligero, Pau Riera, Amine El-Amrani, Victor Bazan, José M. Guerra, Silvia Herraez, Xavier Viñolas and Josep M. Alegret Subject: Background: Amiodarone is an anti-arrhythmic drug that has extensive tissue distribution and substantial storage in the fat tissue. Different studies have described some implications of body fat composition in its pharmacokinetics and pharmacodynamics. However, no clinical studies have described its implications for clinical efficacy. Methods: We studied 878 patients with persistent atrial fibrillation (AF) treated with a regimen of amiodarone and referred to electrical cardioversion (ECV), included prospectively in two Spanish registries. We analyzed the influence of body mass index (BMI), as well as overweight and obesity, in the efficacy of amiodarone for achieving pharmacologic cardioversion to sinus rhythm (SR) before ECV. Results: A total of 185 patients (21.1%) reverted to SR before ECV. Patients who reverted to SR had a lower BMI than those who did not revert (27.45 4.36 kg/m2 vs. 29.11 4.09 kg/m2; p < 0.001). We observed a progressively lower probability of reverting to SR in overweight and obese patients (normal weight 28.3%, overweight 21.3%, obesity 13.1%; p < 0.001). In the logistic regression, BMI (kg/m2) adjusted for other related variables remained as the main factor inversely related to reversion to SR (OR = 0.904 kg/m2); CI 75% 0.864 0.946). Conclusions: We observed a negative relationship between an increased BMI and the efficacy of amiodarone for reversion to SR, suggesting a negative clinical impact of excess body fat in its efficacy. 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