Why the study?
Sex-specific differences in clinical outcomes after pulmonary vein isolation for atrial fibrillation remain controversial, and the impact of BMI on sex-based outcome variations is not well understood.
Does sex and body mass index impact the recurrence of atrial fibrillation after pulmonary vein isolation?
Does sex and body mass index impact the recurrence of atrial fibrillation after pulmonary vein isolation?
Female sex, particularly when combined with high BMI and prolonged left atrial conduction indices, is associated with a significantly higher risk of AF recurrence after pulmonary vein isolation.
Women with high BMI may need intensified post-PVI surveillance; extends evidence on sex-specific recurrence predictors.
ABSTRACT Background Sex-specific differences in the clinical outcome of pulmonary vein isolation (PVI) in patients with atrial fibrillation (AF) remain controversial. The impact of body mass index (BMI) on sex-based variation in the outcome of PVI is not well understood. Objective We sought to investigate the impact of BMI with associated atrial conduction indices (ACI) on sex-specific differences in AF recurrence after PVI. Methods All consecutive patients who underwent first PVI for AF from 2014 to 2019 were included. ACI were measured on surface electrocardiogram (ECG) and intracardiac electrogram (EGM). Data was collected and analyzed based on BMI and sex. Results The study included 387 patients with AF (121 women and 266 men; mean age 66 years; 49.2% with BMI ≥30). Women were older at the time of the procedure (median age 67 versus 62 years, P<0.001). AF recurrence was more common in women (57% versus 44.4%) during a mean 5±3 years follow up (P=0.027). All-cause mortality was similar in men and women after PVI, irrespective of AF recurrence (P>0.05). Post-PVI atrial flutter (AFL) occurred more often in women (21.5% versus 10.9%, P=0.009). Female sex, enlarged left atria, prolonged ACI, and post-PVI AFL were predictors of AF recurrence (P<0.05). High BMI and prolonged left ACI were associated with recurrence of AF in women. Conclusion Female sex was associated with higher risk of AF recurrence after PVI and post-PVI AFL. Women with high BMI and prolonged left ACI had the highest rate of AF recurrence. This highlights the importance of weight management.
No takes yet. Share an insight, caveat, or question.
Özcan et al. (2026) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: