Key result
In patients undergoing pulmonary vein isolation for atrial fibrillation, obesity was not associated with an increased risk of AF recurrence compared to non-obese patients (39.2% vs 43.7%).
Why the study?
A reduced effectiveness of pulmonary vein isolation has been observed in obese patients, in whom AF occurs more frequently.
Does pulmonary vein isolation have similar long-term efficacy and safety in obese compared to non-obese patients with atrial fibrillation?
Cohort (n=226)
No
Does pulmonary vein isolation have similar long-term efficacy and safety in obese compared to non-obese patients with atrial fibrillation?
Absolute Event Rate: 39.2% vs 43.7%
Pulmonary vein isolation is safe and effective in obese patients, with similar long-term AF recurrence rates compared to non-obese patients, suggesting high BMI alone should not preclude patients from undergoing the procedure.
Introduction: Pulmonary vein isolation (PVI) is an established procedure used to achieve rhythm control in atrial fibrillation (AF). In obese patients (pts), in whom AF occurs more frequently, a reduced effectiveness of PVI has been observed. Therefore, this study’s aim was to compare the long-term efficacy of PVI between obese and non-obese patients. 2. Methods: We enrolled 111 consecutive pts with a body mass index (BMI) of >30 kg/m2 undergoing PVI from our large registry. Procedural data and outcomes were compared with a matched group of 115 non-obese PVI pts and the long-term outcomes were analyzed. 3. Results: Overall follow-up duration was 314 patient-years in the obese and 378 patient-years in the non-obese group. The follow-up rate was 71% in the obese and 76% in the non-obese group. In both groups, their AF-characteristics did not differ significantly, while known risk factors were significantly more prevalent in the obese group. Procedural characteristics were similar in both groups. During follow-up, the obese pts demonstrated significant weight loss compared to the non-obese pts, while at the same time, the overall recurrence rate during follow-up did not differ significantly between both groups (obese: 39.2% and non-obese: 43.7%). PVI related and long-term complications were comparable between both groups. In the univariate analysis, obesity was not found to be associated with an increased AF recurrence risk. 4. Conclusion: These real-life data demonstrate that obese pts may not show higher AF recurrence rates after PVI compared to pts with normal body weight. Furthermore, PVI was found to be safe and effective in obese patients; thus, a BMI alone may not be a criterion for refusal of PVI.
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Wolfes et al. (2022) conducted a cohort in Atrial fibrillation (n=226). Obesity (BMI >30 kg/m2) vs. Non-obese patients was evaluated on Atrial fibrillation recurrence rate. In patients undergoing pulmonary vein isolation for atrial fibrillation, obesity was not associated with an increased risk of AF recurrence compared to non-obese patients (39.2% vs 43.7%).
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