Volume 11, Issue 100 November 7, 2014
When losing weight
could cause atrial fibrillation
Last week I had a patient come in who had an arrhythmia called atrial fibrillation. People with atrial fibrillation are roughly six times more likely to have a stroke. She developed it several days after having a lap band surgery. Now she has to be on medications for it for the rest of her life. And ironically enough, as much as she needs to exercise to help with her weight and overall health she is limited by the atrial fibrillation. She asked me if the arrhythmia could have been caused by the surgery. So I looked into it.

There are very little reports on this issue. In fact, I could find only one. That was reported way back in 1988. And it didn’t report on lap band surgeries. The authors examined data coming from 50,314 morbidly obese patients who underwent surgeries for weight loss. This was before the lap band era. The authors discovered that the rate of death from unexplained cardiac arrests (the heart stops secondary to an arrhythmia) was 40 times what it is in the general population. They noted that three-fourths of those who died had a specific finding on their pre-operative cardiogram. For the technically minded it was an abnormally long Q-T interval. So what’s the answer to my patient’s question?

The answer is I don't know. Atrial fibrillation after lap band surgery has not been reported in the literature. But it is still possible that the surgery brought on the problem. Lap band surgeries consist of a band of material being placed around the upper part of the stomach. The band is then tightened to limit the amount of food that can go into the stomach. Basically it is a way for people without enough will power to be forced to eat less. But here’s the problem. The band is placed very close to the vagus nerve. And the vagus nerve is instrumental in controlling heart rhythm. It is not hard to imagine that the localized pressure caused by the lap band could affect the vagus nerve. So it is possible that my patient’s arrhythmia could have been caused by the band.

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I also checked several blog sites to see what other lap band patients were saying. Several of them reported atrial fibrillation after their surgeries as well. And several others reported that they had atrial fibrillation before lap band surgery and that it was much more difficult to control after the surgery.

So in conclusion, if I was interested in possibly having this surgery I would definitely have my Q-T interval checked. If it was abnormal, I would not do it. But then I would not advise anyone to have the surgery even if their Q-T interval was normal. Here's why.

Regardless of whether or not these surgeries cause arrhythmias, they are not all that effective. Although there are many complexities as to why certain people have an issue with weight, there is only one basic cause. People who are overweight have been eating more calories than their metabolism can handle. There are two ways to correct for this. The most obvious is to eat less. That is the rationale behind the lap band surgery. The other way is to increase the metabolism. Lap band surgeries don’t do that. But, in fact, a low metabolism may be the biggest problem with weight management. And that is probably why they don’t work very well. 

A recent study looked at the effectiveness of lap band surgery. The researchers looked at 2,909 patients. After three years on average, they had lost 53% of their excess weight. This level of weight loss was maintained for the next six years. The authors did not report on what happened after then. So the conclusion is that the surgery works, but it can get off only 50% of the weight. Why? It’s because of metabolism. None of these patients are getting their metabolism corrected. And that's half the problem.

Also, it turns out that lap bands don't last forever. Even if the patient has a good experience with a lap band, eventually it will wear out. The European School of Laparoscopic Surgery followed lap band patients for 12 years and found that half had their bands removed within that period of time.

So here you have a surgical procedure that only accomplishes half of its goal, and for many people will stop working at some point. There is a better alternative in my opinion. And that is to correct metabolism and adapt to eating less. This means determining how many calories your body actually needs and sticking to that number. It also means having your metabolism measured and improved. Both of these goals can be met with a testing process I developed 15 years ago called Bio-Energy Testing®. You can find a doctor who offers this test at www.bioenergytesting.com. I have been successfully using this approach for years.

Yours for better health,

REF:

Poirier P, Cornier MA, Mazzone T, et al. Bariatric surgery and cardiovascular risk factors: a scientific statement from the American Heart Association. Circulation. 2011 Apr 19;123(15):1683-701.

Drenick EJ, Fisler JS. Sudden cardiac arrest in morbidly obese surgical patients unexplained after autopsy. Am J Surg. 1988 Jun;155(6):720-6.

Weichman K, Ren C, Kurian M, et al. The effectiveness of adjustable gastric banding: a retrospective 6-year U.S. follow-up study. Surg Endosc. 2011 Feb;25(2):397-403.

Himpens, J., Cadière, G., Bazi, et al. Long-term outcomes of laparoscopic adjustable gastric banding. Archives of Surgery, 146(7), 802-807.

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