TY  - JOUR
A1  - Providência, Rui
A1  - Adragão, Pedro
A1  - Asmundis, Carlo de
A1  - Chun, Kyoung-Ryul Julian
A1  - Chierchia, Gianbattista
A1  - Defaye, Pascal
A1  - Anselme, Frederic
A1  - Creta, Antonio
A1  - Lambiase, Pier D.
A1  - Schmidt, Boris
A1  - Chen, Shaojie
A1  - Cavaco, Diogo
A1  - Hunter, Ross J.
A1  - Carmo, João
A1  - Combes, Stephane
A1  - Honarbakhsh, Shohreh
A1  - Combes, Nicolas
A1  - Sousa, Maria João
A1  - Jebberi, Zeynab
A1  - Albenque, Jean-Paul
A1  - Boveda, Serge
T1  - Impact of body mass index on the outcomes of catheter ablation of atrial fibrillation: A European observational multicenter study
T2  - Journal of the American Heart Association
N2  - Background: Outcomes of catheter ablation of atrial fibrillation (AF) are variable and the predictors of success require further elucidation since the identification of correctable risk factors could help to optimize therapy. We aimed to assess the impact of body mass index (BMI) in the overall safety and efficacy of catheter ablation of AF, with emphasis on the use of cryoballoon ablation and novel oral anticoagulants.
Methods and Results: There were 2497 consecutive patients undergoing catheter ablation of AF in 7 European high volume centers were stratified according to BMI (normal weight <25 kg/m2, pre‐obese 25–30 kg/m2, obesity 30–35 kg/m2, and morbid obesity ≥35 kg/m2) and comparisons of procedural outcomes evaluated. Pre‐obese and obese patients presented more comorbidities (hypertension, diabetes mellitus, and sleep apnea), and had higher rates of non‐paroxysmal AF ablation procedures. The rate of atrial 12‐month arrhythmia relapse increased alongside with BMI (35.2%, 35.7%, 43.6%, and 48.0% P<0.001). During a median follow‐up of 18.8 months (interquartile range 11–28), after adjusting for all baseline differences, BMI was an independent predictor of relapse (hazard ratio=1.01 per kg/m2; 95% CI 1.01–1.02; P=0.002), adding incremental predictive value to obstructive sleep apnea. BMI was not a predictor for any of the reported complications. Using novel oral anticoagulants and cryoballoon ablation was safe and efficacy was comparable with vitamin‐K antagonists and radiofrequency ablation.
Conclusions: Obese patients present with a more adverse comorbidity profile, more advanced forms of AF, and have lower chances of being free from AF relapse after ablation. Use of novel oral anticoagulants and cryoballoon ablation may be an option in this patient group.
KW  - atrial fibrillation
KW  - metabolic syndrome
KW  - obesity
KW  - sinus rhythm
KW  - vascular complications
Y1  - 2019
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/51091
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-510915
SN  - 2047-9980
N1  - © 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
VL  - 8
IS  - 20, e012253
SP  - 1
EP  - 15
PB  - Association
CY  - New York, NY
ER  -