What This Means
This research suggests that among hospitalized patients with obesity, those who experienced cardiac arrest were older, more likely to be White men, and had more health problems such as high blood pressure, heart disease, heart failure, and irregular heart rhythms. Most strikingly, atrial fibrillation (an irregular heart rhythm) was strongly associated with cardiac arrest in obese patients even after accounting for heart failure, with nearly eight times the odds compared to obese patients without atrial fibrillation. Patients with cardiac arrest also tended to have longer hospital stays, higher medical costs, and worse survival outcomes.
This research also highlights important disparities in who receives implantable cardioverter-defibrillators (ICDs), which are devices that can detect and correct dangerous heart rhythms. Patients with higher incomes, private insurance, and care at large urban teaching hospitals were more likely to receive an ICD after cardiac arrest involving dangerous heart rhythms. Meanwhile, obese patients who did not receive an ICD and had conditions like diabetes, kidney disease, liver disease, or lung disease faced higher odds of dying. Asian, Pacific Islander, and Native American patients without an ICD also had worse survival odds compared to White patients.
These findings suggest that socioeconomic and racial gaps in access to life-saving therapies like ICDs exist among obese patients who survive cardiac arrest. The study underscores the need to better understand which obese patients are at highest risk for cardiac arrest—particularly those with atrial fibrillation—and to address inequities in who receives appropriate cardiac devices and care.