Impact of body mass index on the outcome of catheter ablation of atrial fibrillation. Issue 3 (2nd October 2018)

• Record Type: Journal Article
• Authors: Glover, Benedict M; Hong, Kathryn L; Dagres, Nikolaos; Arbelo, Elena; Laroche, Cécile; Riahi, Sam; Bertini, Matteo; Mikhaylov, Evgeny N; Galvin, Joseph; Kiliszek, Marek; Pokushalov, Evgeny; Kautzner, Josef; Calvo, Naiara; Blomström-Lundqvist, Carina; Brugada, Josep
• Other Names: author non-byline.; Dagres Nikolaos author non-byline.; Brugada Josep author non-byline.; Arbelo Elena author non-byline.; Tavazzi Luigi author non-byline.; Lundqvist Carina Blomström author non-byline.; Pokushalov Evgeny author non-byline.; Kautzner Josef author non-byline.; Maggioni Aldo P author non-byline.; Steinwender Clemens author non-byline.; Chasnoits Alexandr author non-byline.; Mairesse Georges author non-byline.; Balabanski Tosho author non-byline.; Kautzner Josef author non-byline.; Riahi Sam author non-byline.; Nawar Mostafa author non-byline.; El maaty Mervat Abul author non-byline.; Raatikainen Pekka author non-byline.; Anselme Frederic author non-byline.; Lewalter Thorsten author non-byline.; Brodherr Turgut author non-byline.; Efremidis Michalis author non-byline.; Geller Laszlo author non-byline.; Glover Ben author non-byline.; Beinart Roy author non-byline.; Glikson Michael author non-byline.; Gaita Fiorenzo author non-byline.; Rekvava Roin author non-byline.; Kalejs Oskars author non-byline.; Trines Serge author non-byline.; Kalarus Zbigniew author non-byline.; Oliveira Mario Martins author non-byline.; Adragao Pedro author non-byline.; Ciudin Radu author non-byline.; Mikhaylov Evgeny author non-byline.; Sinkovec Matjaz author non-byline.; Villacastin Julian Perez author non-byline.; Blomström-lundqvist Carina author non-byline.; Sychov Oleg author non-byline.; Roberts Paul author non-byline.; Daniel scherr Graz D author non-byline.; Manninger Martin author non-byline.; Mastnak Bernadette author non-byline.; Pachinger Innsbruck Otamr author non-byline.; Hintringer Florian author non-byline.; Stühlinger Markus author non-byline.; Steinwender Linz Clemens author non-byline.; Xhaet Yvoir Olivier author non-byline.; Tchavdar shalganov Bulgaria Sofia author non-byline.; Stoyanov Milko author non-byline.; Protich Mihail author non-byline.; Traykov Sofia Vassil author non-byline.; Marchov Daniel author non-byline.; Kaninski Genadi author non-byline.; 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• Is Part Of: Heart. Volume 105:Issue 3(2019)
• Page Start: 244
• Page End: 250
• Publication Date: 2018-10-02
• Subjects: atrial fibrillation -- catheter ablation -- obesity; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2018-313490
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objectives: The association between obesity and atrial fibrillation (AF) is well-established. We aimed to evaluate the impact of index body mass index (BMI) on AF recurrence at 12 months following catheter ablation using propensity-weighted analysis. In addition, periprocedural complications and fluoroscopy details were examined to assess overall safety in relationship to increasing BMI ranges. Methods: Baseline, periprocedural and follow-up data were collected on consecutive patients scheduled for AF ablation. There were no specific exclusion criteria. Patients were categorised according to baseline BMI in order to assess the outcomes for each category. Results: Among 3333 patients, 728 (21.8%) were classified as normal (BMI <25.0 kg/m 2 ), 1537 (46.1%) as overweight (BMI 25.5–29.0 kg/m 2 ) and 1068 (32.0%) as obese (BMI ≥30.0 kg/m 2 ). Procedural duration and radiation dose were higher for overweight and obese patients compared with those with a normal BMI (p=0.002 and p<0.001, respectively). An index BMI ≥30 kg/m 2 led to a 1.2-fold increased likelihood of experiencing recurrent AF at 12-months follow-up as compared with overweight patients (HR 1.223; 95% CI 1.047 to 1.429; p=0.011), while no significant correlation was found between overweight and normal BMI groups (HR 0.954; 95% CI 0.798 to 1.140; p=0.605) and obese versus normal BMI (HR 1.16; 95% CI 0.965 to 1.412; p=0.112). Conclusions: Patients with a baseline BMI ≥30 kg/m 2 have a higher recurrence rate of AF following catheter ablation and therefore lifestyle modification to target obesity preprocedure should be considered in these patients.