Abstract 15799: Body Mass Index Modulates Symptomatic Atrial Fibrillation Burden
Bibliographic record
Abstract
Introduction: Atrial fibrillation (AF) is the most common sustained arrhythmia and is associated with significant morbidity and increased mortality. Approximately fifty percent of patients have AF-related symptoms and require rhythm control therapy with antiarrhythmic drugs (AADs) or cathether ablation. Obesity is increasingly recognized as an important risk factor for the development of AF. Hypothesis: We assessed the hypothesis that body mass index (BMI) modulates AF symptom severity. Methods: Cross-sectional data was collected from 1429 patients in the Vanderbilt AF Registry. AF burden was assessed using the Toronto Atrial Fibrillation Severity Scale (AFSS), a validated survey tool measuring the frequency, duration and severity of AF episodes. BMI was categorized according to WHO guidelines, with BMIs of 18.5 kg/m 2 -25 kg/m 2 considered normal, 25 kg/m 2 -30 kg/m 2 overweight, 30 kg/m 2 -35 kg/m 2 obese and >35 kg/m 2 morbidly obese. Patients were grouped according to their current AF treatment regimen; no treatment (n=195), rate control with AV-nodal blocking agents (n=388), rhythm control with AADs (n=678) and prior AF ablation (n=220). Results: Morbidly obese patients had higher AFSS scores than normal and overweight patients in the rate control (43.57 vs 38.21: P=0.0057), AAD (46.61 vs. 41.08: P=0.00016) and ablation (44.01 vs. 39.02: P=0.047) groups. In univariate linear models, BMI was associated with an increase in the AFSS score in the rate control (0.27, 95% CI 0.05-0.5, P=0.0181), AAD (0.38, 95% CI 0.21-0.56, P=2.49 x 10 -5 ) and ablation (0.38, 95% CI 0.03-0.73, P=0.033) groups. The association remained significant in the AAD group after adjusting for age, gender, race, and comorbidities (0.29, 95% CI 0.11-0.49, P=0.0024). Conclusion: In conclusion, our results showed that obesity and increasing BMI were associated with a significant increase in patient-reported measures of AF symptom severity and frequency of AF episodes. The association was most significant in patients on rhythm control therapy with AADs. Further research is needed to determine whether this finding is due to an overlap between subjective obesity-related and AF-related symptoms, or whether obesity may modulate response to rhythm control therapies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".