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