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Obesity negatively affects pulmonary vein isolation outcomes in drug-refractory AF

14 Jun 2018

Among patients with drug-refractory atrial fibrillation (AF), obesity is associated with lower pulmonary vein isolation (PVI) treatment success but not with increased adverse events, as reported in a study.

Researchers looked at 414 consecutive patients (mean age 56 years; 76 percent male) who underwent transcatheter PVI for AF between. PVI was considered successful if patients did not show atrial arrhythmia on Holter monitoring or ECG, with or without antiarrhythmic drugs during follow-up.

Of the patients, 311 (75 percent) had paroxysmal AF and 111 (27 percent) were obese (body mass index [BMI] ≥30 kg/m²). Mean duration of follow-up was 46 months.

Freedom from atrial arrhythmia and antiarrhythmic drugs occurred more frequently in nonobese vs obese patients (46 percent vs 30 percent; p=0.005). The same was true for the outcome of freedom from atrial arrhythmia but not antiarrhythmic drugs (68 percent vs 56 percent; p=0.036).

Minor and major adverse events (AEs), on the other hand, did not differ between patients with and without obesity (major AEs: 6 percent vs 3 percent, respectively; p=0.105; minor AEs: 5 percent vs 5 percent; p=0.512).

Sensitivity analyses revealed an association between BMI (as continuous variable) and PVI outcome (hazard ratio, 1.08; 95 percent CI, 1.02–1.14; p=0.012).

The present data highlight the importance of risk factor management, including weight loss, in patients with symptomatic AF before invasive treatment modalities are deployed, researchers said.

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Most Read Articles
4 days ago
The types of bariatric surgery differentially affect the risk of developing acute pancreatitis postoperatively, such that the risk is greater in patients who undergo vertical sleeve gastrectomy vs Roux-en-Y gastric bypass surgery, according to a study. Risk factors include younger age and presence of gallstones.
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5 days ago
Smoking appears to increase the risk of abdominal aortic aneurysm, particularly among current smokers, reports a recent meta-analysis. The risk appears to taper with a lower number of cigarette sticks smoked per day.
6 days ago
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