Obesità e fibrillazione atriale: epidemiologia, meccanismi e implicazioni terapeutiche nell'era delle terapie metaboliche

Obesity has become a major modifiable risk factor for atrial fibrillation (AF) and contributes significantly to its rising global prevalence. Beyond epidemiological associations, obesity induces a specific form of atrial cardiomyopathy characterized by structural remodeling, fibrosis, expansion of epicardial adipose tissue, inflammation, autonomic imbalance, and metabolic dysfunction, all of which promote AF initiation and progression. This review synthesizes current evidence linking obesity to AF, focusing on epidemiology, pathophysiological mechanisms, and therapeutic implications, including catheter ablation, bariatric surgery, and metabolic pharmacotherapies. The analysis is based on a s