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Impact of pre‐ablation weight loss on the success of catheter ablation for atrial fibrillation
Author(s) -
Peigh Graham,
Wasserlauf Jeremiah,
Vogel Kelly,
Kaplan Rachel M.,
Pfenniger Anna,
Marks Daniel,
Mehta Arjun,
Chicos Alexandru B.,
Arora Rishi,
Kim Susan,
Lin Albert,
Verma Nishant,
Patil Kaustubha D.,
Knight Bradley P.,
Passman Rod S.
Publication year - 2021
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/jce.15141
Subject(s) - medicine , ablation , atrial fibrillation , weight loss , cardiology , catheter ablation , body mass index , odds ratio , confidence interval , overweight , clinical endpoint , pulmonary vein , retrospective cohort study , surgery , obesity , randomized controlled trial
Obesity is an established risk factor for recurrent atrial fibrillation (AF) after ablation. The impact of pre‐procedure weight changes on freedom from AF (FFAF) after ablation in obese and nonobese patients is unknown. Methods A single‐center retrospective cohort study of patients undergoing pulmonary vein isolation was performed. Before ablation, all candidates were encouraged to adopt healthy lifestyle habits according to American Heart Association guidelines, including weight loss, by their physician. The primary endpoint was FFAF through 1‐year after completion of the 3‐month blanking period. Results Of the 601 patients (68% male; average age 62.1 ± 10.3 years) included in analysis, 234 patients (38.9%) were obese (body mass index ≥ 30) and 315 (52.4%) had paroxysmal AF. FFAF was observed in 420 patients (69.9%) at 15 months. Percent change in weight that occurred during the year before ablation independently predicted FFAF through 15‐months in all patients (adjusted odds ratio = 1.17, 95% confidence interval: 1.11–1.23). Subgroup analyses based on paroxysmal vs persistent AF, presence of obesity, and history of prior ablation were performed. Percent change in weight over the year before ablation was independently associated with FFAF in all subgroups except nonobese patients with persistent AF. Conclusion Pre‐ablation weight loss was associated with FFAF in both obese and nonobese patients. Further studies are needed to define the optimal approach to weight loss before AF ablation.