Introduction:

Weight loss after bariatric surgery in obese patients reduces stroke risk; however, it is not known if similar benefits are maintained for all patients and whether atrial fibrillation (AF) plays a major role in stroke after weight loss.

Methods: Descriptive statistics were used for category and continuous variables and Cox regression analysis and predictors of stroke events were identified.

Results:Out of 847 morbidly obese patients [body mass index (BMI) ≥35 kg/m2] who underwent laparoscopic adjustable gastric banding (LAGB) and were followed for 11 years (mean age 44±11 years, mean BMI 49±8 kg/m2), incident stroke occurred in 44 (5.2%) patients. AF was present in eight patients (18%) at the time of LAGB who later developed stroke. New onset AF after LAGB developed in 38 (4.5%) patients over a median follow-up of 63.6 months, which was complicated by stroke in 5 patients. Of all patients who developed stroke, AF was documented in 13 patients (30%), while majority had no documented AF (n=31; 70%). On multivariate analysis, obstructive sleep apnea (HR=6.0; 95% CI 3.0- 12.1, p

Conclusions: In patients with morbid obesity who have undergone LAGB both non-AF and AF-related factors were involved in increasing the risk of stroke. Further investigation is warranted to define the relation between stroke with obstructive sleep apnea and Hispanic ethnicity.