Key result
Moderate-to-severe malnutrition linked to ~546% higher risk of procedural complications after AF catheter ablation.
Why the study?
Little was known about the prognostic value of nutritional status among patients undergoing atrial fibrillation catheter ablation.
Does malnutrition increase the risk of procedural complications and affect long-term rhythm outcomes in patients with atrial fibrillation undergoing catheter ablation?
Cohort (n=3,239)
Yes
Does malnutrition increase the risk of procedural complications and affect long-term rhythm outcomes in patients with atrial fibrillation undergoing catheter ablation?
Malnutrition, as assessed by the CONUT score, is a strong independent predictor of procedural complications in patients undergoing atrial fibrillation catheter ablation, although it does not impact long-term rhythm outcomes.
Answers are grounded in this paper and cite their sources.
Malnutrition screening may identify higher-risk AF ablation patients; leaves open whether correction reduces complications.
Background: Little is known about the prognostic value of nutritional status among patients undergoing atrial fibrillation (AF) catheter ablation (AFCA). We compared the risk of procedure-related complications and long-term rhythm outcomes of AFCA according to nutritional status. Methods: We included 3,239 patients undergoing de novo AFCA in 2009-2020. Nutritional status was assessed using the controlling nutritional status (CONUT) score. The association between malnutrition and the risk of AFCA complications or long-term rhythm outcomes was evaluated. We validated the effects of malnutrition using an external cohort of 360 patients undergoing AFCA in 2013-2016. Results: In the study population (26.8% women, median age: 58 years), 1,005 (31.0%) had malnutrition (CONUT scores ≥ 2); 991 (30.6%) had mild (CONUT 2–4) and 14 (0.4%) had moderate-to-severe (CONUT ≥ 5) malnutrition. The overall complication rates after AFCA were 3.3% for normal nutrition, 4.2% for mild malnutrition, and 21.4% for moderate-to-severe malnutrition. Moderate-to-severe malnutrition [odds ratio (OR) 6.456, 95% confidence interval (CI) 1.637-25.463, compared with normal nutrition], older age (OR 1.020 per 1-year increase, 95% CI 1.001-1.039), female sex (OR 1.915, 95% CI 1.302-2.817), and higher systolic blood pressure (OR 1.013 per 1-mmHg increase, 95% CI 1.000-1.026) were independent predictors for the occurrence of complications. In the validation cohort, malnutrition (CONUT ≥ 2) was associated with a 2.87-fold higher risk of AFCA complications (95% CI 1.174-7.033). The association between malnutrition and a higher risk of AFCA complications was consistently observed regardless of body mass index and sex. Malnutrition did not affect rhythm outcomes during the median follow-up of 40 months (clinical recurrence: 37.0% in normal nutrition vs. 36.5% in malnutrition). Conclusion: Malnutrition, which is common in patients undergoing AFCA, was associated with a substantially higher risk for complications after AFCA.
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Kim et al. (2021) conducted a cohort in Atrial fibrillation (n=3,239). Moderate-to-severe malnutrition (CONUT score ≥ 5) vs. Normal nutrition (CONUT score 0-1) was evaluated on Overall procedure-related complications (OR 6.456, 95% CI 1.637-25.463, p=0.008). Moderate-to-severe malnutrition was associated with a substantially higher risk of procedural complications after atrial fibrillation catheter ablation compared to normal nutrition (OR 6.456).
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