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(Circulation. 2008;117:1249-1251.)
© 2008 American Heart Association, Inc.

Editorial

Atrial Fibrillation Susceptibility in Metabolic Syndrome

Simply the Sum of Its Parts?

John T. Nguyen, MD; David G. Benditt, MD

From the Cardiac Arrhythmia Center, Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis.

Correspondence to David G. Benditt, MD, Mail Code 508, 420 Delaware St SE, Minneapolis, MN, 55455. E-mail bendi001@umn.edu

Key Words: Editorials • arrhythmia • electrocardiography • metabolism • atrial fibrillation • metabolic syndrome X

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
In this issue of Circulation, Watanabe et al¹ demonstrate an apparent correlation between the presence of metabolic syndrome (MS) and increased susceptibility to atrial fibrillation (AF) in a relatively large (>28 000 subjects) community-based cohort in Japan. The study’s strength, apart from the size of the population, lies in its prospective assessment of free-living individuals without evidence of AF on entry into the study. As such, this report provides new insight into the prevalence of MS in Japan, and in addition, highlights an underappreciated health risk (ie, AF susceptibility) associated with the syndrome. On the other hand, applicability of the findings in the report from Watanabe et al¹ is importantly constrained by several key methodologic limitations. First, both the study population as a whole and the subsets with MS features incorporated a high proportion of females (66%). The basis for the make up of the cohort, which was 34% male, is unclear, but the sex imbalance suggests that men in the community were less compliant with the voluntary health screening process offered by the prefecture. Second, the prevalence of MS in the study population (13% to 16% depending on the MS definition used) was substantially higher than the approximate 6% previously reported from Japan.² The basis for this seemingly substantial difference is unknown, but it may reflect selection bias due to less healthy individuals electing to come for screening. Finally, the study protocol did not include a comprehensive effort to document AF by long-term ambulatory ECG monitoring. This failing . . . [Full Text of this Article]