Obese patients with atrial fibrillation (AF) are frequently treated with AF ablation.
We sought to examine whether a body mass index (BMI) threshold exists beyond which
the odds of experiencing a complication from AF ablation increases. All patients enrolled
in the Vanderbilt AF Registry who underwent catheter-based AF ablation from May 1999
to February 2012 were included. Major complications were recorded. Morbid obesity
was defined as a BMI >40 kg/m2 and examined in multivariable analysis. A total of 35 complications (6.8%) occurred
in 512 ablations. Morbidly obese patients experienced a greater rate of complications
(6 of 42, 14.3%) than the nonmorbidly obese (29 of 470, 6.2%; p = 0.046). Using a
discrete BMI cutoff, the odds of complications increased 3.1-fold in those with morbid
obesity (odds ratio [OR] 3.1, 95% confidence interval [CI] 1.1 to 8.4, p = 0.03) and
2.1-fold for female gender (OR 2.1, 95% CI 1.04 to 4.38, p = 0.04). With BMI as a
continuous variable, the odds of complications increased by 5% per 1 unit increase
in BMI (OR 1.05, 95% CI 1.0 to 1.11, p = 0.05), and the increase for female gender
was 2.2-fold (OR 2.2, 95% CI 1.1 to 4.6, p = 0.03). In conclusion, morbid obesity
represents a BMI threshold above which the odds of complications with AF ablation
increase significantly. The increase in complications appears to be driven primarily
by events in women, suggesting that morbidly obese women are a special population
when considering AF ablation.
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Article Info
Publication History
Published online: November 19, 2012
Accepted:
October 15,
2012
Received in revised form:
October 15,
2012
Received:
August 9,
2012
Footnotes
This study was supported by Established Investigator award 0940116N from the American Heart Association (Dallas, Texas) and Clinical Research Program award 11CRP7420009 from the American Heart Association (Dallas, Texas), and grants U19 HL65962 , HL092217 , UL1 RR024975 , and UL1 TR000445 from the National Institutes of Health (Bethesda, Maryland).
See page 372 for disclosure information.
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© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
