Key result
Preoperative undernutrition linked to ~66% higher atrial tachyarrhythmia recurrence after catheter ablation.
Why the study?
The relationship between nutritional status and outcomes after catheter ablation for atrial fibrillation has not been described using various nutritional scoring tools.
Does preoperative undernutrition status predict atrial tachyarrhythmia recurrence in patients undergoing catheter ablation for atrial fibrillation?
Cohort (n=913)
No
Does preoperative undernutrition status predict atrial tachyarrhythmia recurrence in patients undergoing catheter ablation for atrial fibrillation?
Hazard Ratio: 1.66 (95% CI 1.15–2.42)
p-value: p=0.008
Preoperative undernutrition, particularly as assessed by the Geriatric Nutritional Risk Index, is an independent predictor of atrial tachyarrhythmia recurrence after catheter ablation for atrial fibrillation.
May warrant preoperative nutritional assessment before AF ablation; leaves open whether optimization reduces recurrence.
BACKGROUND: The relationship between nutritional status and the incidence or prognosis of atrial fibrillation (AF) has been reported, but no studies have described the relationship between the outcomes of AF catheter ablation (CA) and nutritional status as assessed by various scoring tools. We aimed to verify the hypothesis that preoperative nutritional status is associated with arrhythmia recurrence after CA for AF. METHODS AND RESULTS: We evaluated 913 patients (age, 67±10 years; men, 72%; paroxysmal AF, 56%) who underwent CA for AF between November 2011 and November 2017. Patients were systematically followed with an endpoint of atrial tachyarrhythmia recurrence, the predictive value of which was compared among 3 scoring tools (Controlling Nutritional Status [CONUT] score / Geriatric Nutritional Risk Index [GNRI] / Prognostic Nutritional Index [PNI]). Patients were divided into normal nutrition (CONUT <2 [n=637] / GNRI >98 [n=836] / PNI >38 [n=910]) and undernutrition (CONUT ≥2 [n=276] / GNRI ≤98 [n=77] / PNI ≤3 [n=3]) groups. AF recurred in 274 patients (mean follow-up, 2.3±0.8 years). The AF recurrence rate was higher in patients with undernutrition than in those with normal nutrition (CONUT/GNRI) status. Multivariate Cox regression analysis identified undernutrition status (GNRI ≤98) as an independent predictor of atrial tachyarrhythmia recurrence. CONCLUSIONS: The AF recurrence rate after CA was higher in patients with undernutrition than in those with normal nutrition as stratified by the nutrition scoring tools.
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Furui et al. (2021) conducted a cohort in Atrial Fibrillation (n=913). Preoperative undernutrition (GNRI ≤98) vs. Normal nutrition (GNRI >98) was evaluated on Recurrence of atrial tachyarrhythmia beyond a blanking period of 90 days (HR 1.66, 95% CI 1.15-2.42, p=0.008). Preoperative undernutrition, assessed by a Geriatric Nutritional Risk Index score of 98 or less, independently increased the risk of atrial tachyarrhythmia recurrence after catheter ablation (HR 1.66).
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