Introduction: Weight loss after bariatric surgery in morbidly obese patients reduces atrial fibrillation (AF); however it is not known if similar benefits are maintained in patients with and without obstructive sleep apnea (OSA). We sought to determine whether weight loss after laparoscopic adjustable gastric banding (LAGB) had a similar effect on new onset AF event rates in patients with and without OSA.

Methods: Differences in LAGB-induced weight loss on incident AF in those with OSA and matched non-OSA patients were determined by Kaplan-Meier and Cox regression analysis and predictors of AF after LAGB indentified.

Results:Out of 843 morbidly obese patients [body mass index (BMI) ≥35 kg/m2] who underwent LAGB (mean age 44±11 years, mean BMI 49±8 kg/m2) and were followed for 11 years, new onset AF was documented in 38 (4.5%). The mean reduction in BMI over the median follow-up of 63.6 months was 11 kg/m2. Despite similar weight loss, patients with OSA had significantly higher rate of incident AF compared to those without OSA (Figure; at 5 years 9.8% vs 1.8%, p

Conclusions: Patients with OSA, despite a similar weight loss to those without OSA after LAGB, had a significantly higher rate of AF events. Further investigation is warranted into whether compliance with OSA treatment helps reduce AF events.