Why the study?
The shape of the dose-response relationship between body mass index and atrial fibrillation recurrence in patients who have undergone radiofrequency ablation was unknown.
Does higher body mass index increase the risk of atrial fibrillation recurrence in patients who have undergone radiofrequency ablation?
Does higher body mass index increase the risk of atrial fibrillation recurrence in patients who have undergone radiofrequency ablation?
Overweight and obesity are significantly associated with a dose-dependent increase in the risk of atrial fibrillation recurrence following radiofrequency ablation.
Elevated BMI may raise AF recurrence risk post-ablation; supports weight management but leaves open need for RCTs.
Objectives The aim of this study was to evaluate the shape of the dose-response relationship between body mass index (BMI) and atrial fibrillation (AF) recurrence in patients who have undergone radiofrequency ablation. Methods Studies investigating BMI and AF recurrence in patients with AF after ablation were identified through electronic searches in the PubMed, EMBASE, and Cochrane Library databases. The potential non-linear relationship was fitted using robust error meta-regression. Our study was registered with PROSPERO (CRD42019121373). Results Twenty-six cohort studies with 7,878 cases/26,450 individuals were included, and a linear dose-response relationship between BMI and AF recurrence ( P non–linearity = 0.12) was found. The risk of AF recurrence in patients with a BMI over 28 was significantly increased. Specifically, for each 5 kg/m 2 increase in BMI, the risk of AF recurrence increased by 15% (95% CI: 1.08–1.22) with moderate heterogeneity ( I 2 = 53%). Subgroup analyses showed that the pooled risk ratio was not significantly changed in subgroup analysis adjustment for the following important potential intermediate factors: left atrial diameter and obstructive sleep apnea. Conclusion This study showed that there is a borderline positive linear association between BMI and AF recurrence post ablation. Overweight and obesity are significantly associated with AF recurrence. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/ , identifier CRD42019128770.
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Liu et al. (2023) studied this question.
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