Catheter ablation for atrial fibrillation in patients with obesity.
BACKGROUND
Obesity is a risk factor for atrial fibrillation and other cardiovascular conditions. Our objective was to determine whether catheter-based ablation effectively treated atrial fibrillation in obese patients.


RESULTS
Five hundred twenty-three consecutive patients with symptomatic, medication-refractory atrial fibrillation underwent catheter ablation. Patients were grouped by body mass index (lean, < 25 kg/m(2); overweight, 25 to 29.9 kg/m(2); obese, > or = 30 kg/m(2)). Outcome and quality of life were measured with a general health survey (Medical Outcomes Study 36-item Short-Form General Health Survey [SF-36]); patients were assessed before ablation and at 3 and 12 months after the procedure. Two hundred twenty-eight study patients (44%) were overweight, and 201 (38%) were obese. Twelve months after curative ablation, 72% of patients were free of atrial fibrillation without the use of antiarrhythmic agents; 84% were arrhythmia free when those receiving medication were included. Atrial fibrillation was eliminated in 75%, 72%, and 70% of the lean, overweight, and obese patients, respectively, at 12 months (P=0.41, trend test). SF-36 scores were lower for patients with higher body mass index (P<0.05) at baseline. SF-36 scores improved in every functional domain for all body mass index groups after ablation. The mean SF-36 total physical score increased from 59+/-20 at baseline to 77+/-19 in 12 months (P<0.001). The total mental health score improved from 66+/-18 to 79+/-16 in 12 months (P<0.001).


CONCLUSIONS
Catheter ablation of atrial fibrillation was effective in obese patients. Coexistence of atrial fibrillation and obesity indicated lower SF-36 scores, but the improvement in quality of life was consistent across all body mass index categories.
Cha
Yong-Mei
YM
Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. ycha@mayo.edu
Friedman
Paul A
PA
Asirvatham
Samuel J
SJ
Shen
Win-Kuang
WK
Munger
Thomas M
TM
Rea
Robert F
RF
Brady
Peter A
PA
Jahangir
Arshad
A
Monahan
Kristi H
KH
Hodge
David O
DO
Meverden
Ryan A
RA
Gersh
Bernard J
BJ
Hammill
Stephen C
SC
Packer
Douglas L
DL
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications* / Q000628:therapy*; D015992:Body Mass Index; D017115:Catheter Ablation / Q000379:methods*; D003625:Data Collection; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011788:Quality of Life; D016896:Treatment Outcome