{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,23]],"date-time":"2026-03-23T01:56:42Z","timestamp":1774231002963,"version":"3.50.1"},"reference-count":39,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T00:00:00Z","timestamp":1716854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Background: Amiodarone is an anti-arrhythmic drug that has extensive tissue distribution and substantial storage in the fat tissue. Different studies have described some implications of body fat composition in its pharmacokinetics and pharmacodynamics. However, no clinical studies have described its implications for clinical efficacy. Methods: We studied 878 patients with persistent atrial fibrillation (AF) treated with a regimen of amiodarone and referred to electrical cardioversion (ECV), included prospectively in two Spanish registries. We analyzed the influence of body mass index (BMI), as well as overweight and obesity, in the efficacy of amiodarone for achieving pharmacologic cardioversion to sinus rhythm (SR) before ECV. Results: A total of 185 patients (21.1%) reverted to SR before ECV. Patients who reverted to SR had a lower BMI than those who did not revert (27.45 \u00b1 4.36 kg\/m2 vs. 29.11 \u00b1 4.09 kg\/m2; p &lt; 0.001). We observed a progressively lower probability of reverting to SR in overweight and obese patients (normal weight 28.3%, overweight 21.3%, obesity 13.1%; p &lt; 0.001). In the logistic regression, BMI (kg\/m2) adjusted for other related variables remained as the main factor inversely related to reversion to SR (OR = 0.904 \u00d7 kg\/m2); CI 75% 0.864\u20130.946). Conclusions: We observed a negative relationship between an increased BMI and the efficacy of amiodarone for reversion to SR, suggesting a negative clinical impact of excess body fat in its efficacy.<\/jats:p>","DOI":"10.3390\/ph17060693","type":"journal-article","created":{"date-parts":[[2024,5,28]],"date-time":"2024-05-28T03:48:49Z","timestamp":1716868129000},"page":"693","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Impact of Body Mass Index in the Cardioverter Efficacy of Amiodarone in Persistent Atrial Fibrillation"],"prefix":"10.3390","volume":"17","author":[{"given":"Carmen","family":"Ligero","sequence":"first","affiliation":[{"name":"Servei de Cardiolog\u00eda, Hospital Universitari de Sant Joan, Institut d\u2019Investigaci\u00f3 Sanit\u00e0ria Pere Virgili, Grup de Recerca Cardiovascular, Universitat Rovira i Virgili, 43204 Reus, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3074-3927","authenticated-orcid":false,"given":"Pau","family":"Riera","sequence":"additional","affiliation":[{"name":"Servei de Farmacia, Hospital de la Santa Creu i Sant Pau, Universitat Aut\u00f2noma de Barcelona, 08025 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9244-2994","authenticated-orcid":false,"given":"Amine","family":"El-Amrani","sequence":"additional","affiliation":[{"name":"Servei de Cardiolog\u00eda, Hospital Universitari de Sant Joan, Institut d\u2019Investigaci\u00f3 Sanit\u00e0ria Pere Virgili, Grup de Recerca Cardiovascular, Universitat Rovira i Virgili, 43204 Reus, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8072-7434","authenticated-orcid":false,"given":"Victor","family":"Bazan","sequence":"additional","affiliation":[{"name":"Servei de Cardiolog\u00eda, Hospital Universitari Germans Trias i Pujol, Universitat Aut\u00f2noma de Barcelona, 08916 Badalona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5397-9177","authenticated-orcid":false,"given":"Jos\u00e9 M.","family":"Guerra","sequence":"additional","affiliation":[{"name":"Servei de Cardiolog\u00eda, Hospital de la Santa Creu i Sant Pau, Universitat Aut\u00f2noma de Barcelona, 08025 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9939-1464","authenticated-orcid":false,"given":"Silvia","family":"Herraez","sequence":"additional","affiliation":[{"name":"Servei de Cardiolog\u00eda, Hospital de la Santa Creu i Sant Pau, Universitat Aut\u00f2noma de Barcelona, 08025 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xavier","family":"Vi\u00f1olas","sequence":"additional","affiliation":[{"name":"Servei de Cardiolog\u00eda, Hospital de la Santa Creu i Sant Pau, Universitat Aut\u00f2noma de Barcelona, 08025 Barcelona, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Josep M.","family":"Alegret","sequence":"additional","affiliation":[{"name":"Servei de Cardiolog\u00eda, Hospital Universitari de Sant Joan, Institut d\u2019Investigaci\u00f3 Sanit\u00e0ria Pere Virgili, Grup de Recerca Cardiovascular, Universitat Rovira i Virgili, 43204 Reus, Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1177\/1747493019897870","article-title":"Global epidemiology of atrial fibrillation: An increasing epidemic and public health challenge","volume":"16","author":"Lippi","year":"2021","journal-title":"Int. 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