Relation of morbid obesity and female gender to risk of procedural complications in patients undergoing atrial fibrillation ablation
Open accessAbstract
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/m(2) 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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Obesity has also been linked to a higher radiation dose and complication rate during AF ablation.
“Obesity has also been linked to a higher radiation dose and complication rate during AF ablation.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [303]
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Middeldorp, M. E., Lau, D. H., & Sanders, P. (2019) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.119.007864 · Cited by 2 · see citing works
Qi, R., Liu, H., Zhu, Y., Wu, N., Wang, K., Ding, X., Gu, Z., Li, M., Chen, H., Weizhu, J., et al. (2024) · Current Cardiology Reviews · doi:10.2174/011573403x348844241129111639 · Cited by 1 · see citing works
Das Outcome bei der Behandlung von Vorhofflimmern: Alles nur eine Frage von Gewicht und Fitness?
Herrera‐Siklody, C., & Deisenhofer, I. (2017) · Kardiologie up2date · doi:10.1055/s-0042-122792
Katheterablation von Vorhofflimmern
Lackermair, K., & Estner, H. (2020) · Kardiologie up2date · doi:10.1055/a-0674-6738
Atrial fibrillation in obesity: Weighing up the evidence for catheter ablation
Javed, S., Gupta, D., & Lip, G. Y. H. (2020) · Clinical Cardiology · doi:10.1002/clc.23416
Demographics and procedural data differences of AF ablation
Toso, E., Peyracchia, M., Summa, R. D., Giustetto, C., & Gaïta, F. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-817728-0.00045-0
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Tüm Yönleri ile AF ve Tedavi Yaklaşımları
Çelik, A., Hakgör, A., Çolak, A., Kunak, A. Ü., Sezenöz, B., Şengör, B. G., Arın, C. B., Coşkun, E. Ç., Ersoy, E. I. Y., Aksakal, E., et al. (2022) · Akademisyen Kitabevi eBooks · doi:10.37609/akya.1962
- Authors
- Shoemaker, M. B., Muhammad, R., Farrell, M., Parvez, B., White, B. W., Streur, M., Stubblefield, T., Rytlewski, J., Parvathaneni, S., Nagarakanti, R., Roden, D. M., Saavedra, P., Ellis, C., Whalen, S. P., & Darbar, D.
- Affiliations
- Vanderbilt University Medical Center (US)
- Corresponding author
- Darbar, Dawood
- ORCID
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2013-02
- Volume
- 111
- Issue
- 3
- Pages
- 368-373
- ISSN
- 0002-9149 (ISSN-L)
- PMC
- PMC3546280
- OpenAlex
- W2073835735
- Cited by
- 63
- References
- 23
- Citations by year
- 2025: 2 · 2024: 5 · 2023: 1 · 2022: 6 · 2021: 6 · 2020: 10 · 2019: 5 · 2018: 7 · 2017: 6 · 2016: 4 · 2015: 3 · 2014: 4 · 2013: 4
- FWCI
- 2.26
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- American Heart Association (UL1 RR024975, U19 HL65962, HL092217, UL1 TR000445, 11CRP7420009)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cardiovascular and Diving-Related Complications
- Keywords
- morbid obesity, atrial fibrillation ablation, procedural complications, body mass index, female sex, catheter ablation, obesity as risk factor
- MeSH terms
- Atrial Fibrillation, Electrocardiography, Female, Follow-Up Studies, Humans, Male, Middle Aged, Obesity, Morbid, Postoperative Complications, Prospective Studies, Risk Factors, Sex Factors, Tennessee, Body Mass Index, Incidence, Survival Rate, Confidence Intervals, Odds Ratio, Treatment Outcome, Catheter Ablation, Risk Assessment
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