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Bariatric Surgery

The incidence of cardiac arrhythmias during exercise stress testing: a focus on patients with severe obesity undergoing sleeve gastrectomy

International Journal of Obesity volume 47, pages 175–180 (2023)Cite this article

Subjects

Abstract

Introduction

Obesity is associated with a higher risk of cardiac arrhythmias. Sleeve gastrectomy (SG) is a common bariatric surgery with beneficial effects on weight loss and comorbidities. The study aimed to investigate the prevalence of arrhythmias during maximal exercise testing in patients with moderate-severe obesity and to evaluate the impact of SG on these arrhythmic events.

Methods

All patients with moderate or severe obesity who were considered suitable candidates for SG between June 2015 and September 2020 were recruited. Each patient underwent three incremental, maximal, ECG-monitored cardiopulmonary exercise test 1 month before and 6 and 12 months after SG; the frequency and complexity of ventricular premature beats (VPBs) and atrial premature beats (APBs) have been evaluated during rest, exercise and recovery phases.

Results

Fifty patients with severe obesity (BMI 46.39 ± 7.89 kg/m2) were included in the study. After SG, patients presented a decreased BMI (34.15 ± 6.25 kg/m2 at 6 months post-SG and 31.87 ± 5.99 kg/m2 at 12 months post-SG). At 6 months post-SG, an increase in VPBs, mainly during the recovery phase, was observed. At 12 months post-SG, a reduction in VPBs compared with the 6 months evaluation was showed.

Conclusion

Although in the early post-surgical phase the risk of exercise-induced arrhythmias may be higher, SG does not seem to increase the occurrence of arrhythmias in the long-term. No life-threating arrhythmias were found during post-SG evaluations.

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Fig. 1: Arrhythmic events during maximal exercise testing in patients who received functional evaluations 1 month before, 6 and 12 months after sleeve gastrectomy (SG).

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Acknowledgements

The authors thank Alessandra Fecchio, MD, and the staff of the Sports and Exercise Medicine Division of the Department of Medicine for the valuable support during patients’ evaluations. This research project is part of the Italian initiative of Exercise is Medicine.

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Authors and Affiliations

  1. Sports and Exercise Medicine Division, Department of Medicine, University Hospital of Padova, Via Giustiniani 2, 35128, Padova, Italy

    Marco Vecchiato, Giulia Quinto, Daniel Neunhaeuserer, Francesca Battista, Andrea Gasperetti & Andrea Ermolao

  2. Clinical Network of Sports and Exercise Medicine of the Veneto Region, Padova, Italy

    Marco Vecchiato, Giulia Quinto, Daniel Neunhaeuserer, Francesca Battista, Andrea Gasperetti & Andrea Ermolao

  3. Center for the Study and Integrated Treatment of Obesity (CeSTIO), Internal Medicine 3, Department of Medicine, University Hospital of Padova, Veneto Region, Padova, Italy

    Silvia Bettini, Roberto Vettor & Luca Busetto

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Contributions

All authors participated in the preparation of the manuscript and approved this submission. Conceptualization: MV and AG. Data curation: MV, DN, GQ and SB. Formal analysis: MV, GQ and FB. Investigation: MV, DN, AG and AE. Methodology: MV, FB and LB. Project administration: RV, LB and AE. Supervision: RV and AE. Writing—original draft: MV. Writing—review and editing: MV, DN, GQ, SB, LB and AE.

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Correspondence to Daniel Neunhaeuserer.

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Vecchiato, M., Quinto, G., Neunhaeuserer, D. et al. The incidence of cardiac arrhythmias during exercise stress testing: a focus on patients with severe obesity undergoing sleeve gastrectomy. Int J Obes 47, 175–180 (2023). https://doi.org/10.1038/s41366-022-01252-7

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