Abstract 15861: The Role of Body Mass Index in Cryoballoon Ablation Outcomes for Paroxysmal Atrial Fibrillation

Abstract

Introduction: Cryoballoon ablation (CBA) is recommended for patients with paroxysmal atrial fibrillation (AF) refractory to anti-arrhythmic drugs. However, only 70% of patients benefit from an initial CBA. Obesity is a known risk factor for development of AF but its role in predicting outcomes following CBA for paroxysmal AF remains unclear. Methods: We followed 103 patients (Age 60.6 ± 9.1, 29% women) with paroxysmal AF undergoing CBA for one year post procedure. Recurrence was assessed by documented atrial arrhythmias (AA) on EKG or any form of long-term cardiac rhythm monitoring. Using the body mass index (BMI) as a surrogate marker for obesity, we divided patients into five groups: normal <24.9 kg/m 2 , overweight 25-29.9 kg/m 2 , class 1 obesity 30-34.9 kg/m 2 , class 2 obesity 35-39.9 kg/m 2 and class 3 obesity ≥40 kg/m 2 . A multivariable cox proportional hazard model was used to assess if BMI predicted risk of AA recurrence. Results: Among our study population, 7 (6.7%) had normal BMI and 34 were overweight (33%) while 17 (16.5%), 14 (13.5%) and 8 patients (7.7%) were categorized as class 1, 2 and 3 obesity respectively. After a one year follow up, 19 (18.4%) participants developed recurrence of AA. Baseline demographics were similar between the two groups except for a higher incidence of hypertension in the class 3 obesity group. On a multivariable model adjusted for baseline demographics and risk factors for AF, neither obesity nor overweight predicted recurrence of AA following CBA (Table, p=0.18). Similarly, on Kaplan-Meier analysis, BMI did not effect time to first recurrence of AA (Figure, p=0.07). Conclusion: Obesity is strongly associated with the risk of development of AF. However, in our study population increasing BMI had no influence on the recurrence of AA following CBA for paroxysmal AF.

Body mass index and atrial fibrillation recurrence post ablation: A systematic review and dose-response meta-analysis

“…Supplementary Table 3 provides the detailed reasons for exclusion following the full-text review. Finally, 26 (6)(7)(8)(9)(10)(11)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45) studies were included in present study.…”

“…Twenty-six (6)(7)(8)(9)(10)(11)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45) studies including 7,878 cases/26,450 individuals were included in the dose-response analysis. The summary RR for a 5-unit increase in BMI was 1.15 (95% CI: 1.08-1.22, I 2 = 53%), with moderate heterogeneity (Figure 2).…”