title: Catheter ablation for atrial fibrillation in patients with obesity.
abstract: 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.
authors.affiliation: Division of Cardiovascular Diseases, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. ycha@mayo.edu
authors.forename: Yong-Mei
authors.initials: YM
authors.lastname: Cha
authors.forename: Paul A
authors.initials: PA
authors.lastname: Friedman
authors.forename: Samuel J
authors.initials: SJ
authors.lastname: Asirvatham
authors.forename: Win-Kuang
authors.initials: WK
authors.lastname: Shen
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Munger
authors.forename: Robert F
authors.initials: RF
authors.lastname: Rea
authors.forename: Peter A
authors.initials: PA
authors.lastname: Brady
authors.forename: Arshad
authors.initials: A
authors.lastname: Jahangir
authors.forename: Kristi H
authors.initials: KH
authors.lastname: Monahan
authors.forename: David O
authors.initials: DO
authors.lastname: Hodge
authors.forename: Ryan A
authors.initials: RA
authors.lastname: Meverden
authors.forename: Bernard J
authors.initials: BJ
authors.lastname: Gersh
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Hammill
authors.forename: Douglas L
authors.initials: DL
authors.lastname: Packer
mesh_terms: 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