Catheter Ablation -> Atrial Fibrillation & Atrial Flutter: -> Clinical Trials / Outcomes D-PO03 - Poster Session III (ID 48) Poster

D-PO03-171 - Both Lean And Obese Patients Are Prone To Relapse After Paroxysmal Atrial Fibrillation Ablation (ID 350)


Background: Outcome of atrial fibrillation (AF) ablation across different body mass index (BMI) categories remained controversial. It is unclear whether the “obese paradox” also applies to this scenario.
Objective: To clarify how BMI would affect the outcome of AF ablation.
Methods: Paroxysmal AF (PAF) patients undergoing primary ablation were enrolled from 3 high volume centers (> 2000 cases/yr) worldwide, all of which had established reliable ablation technique and thorough follow-up strategy. Patients were categorized into 4 groups according to their BMI: underweight (<18.5), normal (18.5-24.9), overweight (25.0-29.9) and obese (≥30.0). Every underweight patient with low BMI was matched with 2 or 3 patients in other BMI category using the criteria of gender, age (+/- 3 yrs) and ablation date (+/- 3 mos). Pulmonary vein isolation was the unique procedural endpoint for all patients.
Results: 561 patients were enrolled with 66, 180, 172 and 143 individuals in the underweight, normal, overweight and obese groups respectively. At 12-month after single procedure, underweight patients had the highest recurrence rate (44%) followed by obese (35%), normal BMI (22%) and overweight (18%) patients, presenting a “U” shape relationship between BMI and recurrence rate (Figure left). Same trend was observed at 48-month with multiple procedures (Figure right). Multivariate regression revealed that both underweight (HR 2.1, P=0.002) and obese (HR 1.5, P=0.05) were independently associated with recurrence.
Conclusion: In PAF patients undergoing ablation, a “U” shape relationship between BMI and recurrence rate was demonstrated, indicating that both lean and obese are risk factors of recurrence.