Key result
Obesity shows no significant link to 12-month AF recurrence after cryoballoon pulmonary vein isolation.
Why the study?
Patients with overweight or obesity suffer more often from AF, and studies investigating the safety and feasibility of PVI in these patients have shown varying results.
Does excess weight and obesity affect the safety, procedural parameters, and recurrence of atrial fibrillation in patients undergoing pulmonary vein isolation with the cryoballoon?
Cohort (n=228)
No
Does excess weight and obesity affect the safety, procedural parameters, and recurrence of atrial fibrillation in patients undergoing pulmonary vein isolation with the cryoballoon?
Absolute Event Rate: 86.55% vs 80.9%
p-value: p=0.460
Cryoballoon pulmonary vein isolation is safe and effective in overweight and obese patients, though it is associated with higher radiation exposure for obese patients and operators.
Pulmonary vein isolation (PVI) has become a cornerstone therapy in the treatment of atrial fibrillation (AF). Patients with overweight or obesity suffer more often from AF, and studies investigating the safety and feasibility of PVI in these patients have shown varying results. In this study we analyzed PVI performed with the 2nd generation cryoballoon (CB) with regard to safety, procedure and fluoroscopy time in patients with normal weight, overweight and obesity. We analyzed 228 consecutive patients treated with CB PVI in our hospital in 2018 and 2019. Fifty nine (25.88%) patients presented with normal weight (body mass index (BMI) of > 30). All pulmonary veins (PV) were isolated successfully. Concerning procedural parameters, neither complications, procedural time, nor fluoroscopy time differed significantly. There was a significant increase of dose area product (DAP) in obese patients compared to normal weight and overweight patients (2035.5 ± 1930.1 μ Gym 2 vs. 975.3 ± 814.9 vs. 1325.1 ± 2081.3, p = 0.001) but no significant difference between overweight and normal weight patients (p = 0.611). Our follow-up data of 168 patients (73.68%) observed for 12 months showed no differences in the recurrence of AF in the three BMI groups [80.9% vs. 83.3% (p = 0.733) vs. 86.55% (p = 0.460)]. In conclusion, CB PVI in overweight and obese patients is safe with similar levels of complications and recurrence of AF as patients of normal weight. However, obese patients and operators are exposed to higher radiation doses.
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Blockhaus et al. (2021) conducted a cohort in Atrial fibrillation (n=228). Overweight and obesity vs. Normal weight was evaluated on Recurrence of atrial fibrillation (p=0.460). Overweight and obesity did not significantly affect atrial fibrillation recurrence at 12 months after cryoballoon pulmonary vein isolation (86.55% in obese vs 80.9% in normal weight; p=0.460).
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