Body Mass Index, Obstructive Sleep Apnea, and Outcomes of Catheter Ablation of Atrial Fibrillation
Open accessAbstract
Background: Obesity and obstructive sleep apnea (OSA) are associated with atrial fibrillation (AF). The effects of a large body mass index (BMI) and OSA on the results of radiofrequency catheter ablation (RFA) of AF are unclear. Objective: To evaluate the effect of BMI and OSA on the efficacy of RFA for AF. Methods: RFA was performed in 324 consecutive patients (mean age = 57 ± 11 years) with paroxysmal (234) or chronic (90) AF. OSA was diagnosed by polysomnography in 32 of 324 patients (10%) prior to ablation. Among the 324 patients, 18% had a normal BMI (<25 kg/m 2), 39% were overweight (BMI ≥ 25 kg/m 2 and <30 kg/m 2), and 43% were obese (≥30 kg/m 2). RFA was performed to eliminate complex fractionated atrial electrograms (CFAE) in the pulmonary vein antrum and left atrium. Results: At 7 ± 4 months after a single ablation procedure, 63% of patients without OSA and 41% with OSA were free from recurrent AF without antiarrhythmic drug therapy (P = 0.02). Multivariate analysis including variables of age, gender, type and duration of AF, OSA, BMI, left atrial size, ejection fraction, and hypertension demonstrated that OSA was the strongest predictor of recurrent AF (OR = 3.04, 95% CI: 1.11–8.32, P = 0.03). There was no association between BMI and freedom from recurrent AF. A serious complication occurred in 3 of 324 patients, with no relationship to BMI. Conclusions: OSA is a predictor of recurrent AF after RFA independent of its association with BMI and left atrial size. Obesity does not appear to affect outcomes after radiofrequency catheter ablation of AF.
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No significant difference in atrial fibrillation recurrence was seen in two very small studies and one large retrospective cohort study.
“No significant difference in rate of recurrence was seen, however, in two very small studies712,728 and one large, retrospective cohort study.1217”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [728]
The Study Subjects section describes a cohort of 324 ablation patients. The BMI and Recurrence section reports no significant association between BMI and AF recurrence after adjustment, but it also reports a significant association before adjustment. The unqualified claim omits that distinction; this citation supports only the part about the large cohort, not the two small studies. (LLM, conf=0.85)
Experimental — accuracy not yet measuredA similar increased risk of atrial fibrillation recurrence was reported in several studies that did not systematically screen for OSA, comparing patients with a documented prior OSA diagnosis to those without known OSA.
“A similar increased risk of AF recurrence was reported in several studies that did not systematically screen for OSA, but compared the risk of AF recurrence following ablation procedures in patients with a documented prior diagnosis of OSA to those without known OSA.728–730”
From International Consensus Statement on Obstructive Sleep Apnea (2023) · cites this paper as [728]
Obesity may increase the rate of AF recurrence after catheter ablation, with obstructive sleep apnoea as an important potential confounder.
“Obesity may increase the rate of AF recurrence after catheter ablation, [298][299][300][301] with obstructive sleep apnoea as an important potential confounder.”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [299]
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- Authors
- JONGNARANGSIN, K., CHUGH, A., GOOD, E., MUKERJI, S., DEY, S., CRAWFORD, T., SARRAZIN, J. F., KUHNE, M., CHALFOUN, N., WELLS, D., BOONYAPISIT, W., PELOSI, Jr., BOGUN, F., MORADY, F., & ORAL, H.
- Affiliations
- University of Michigan (US)
- Corresponding author
- JONGNARANGSIN, KRIT
- ORCID
- Venue
- Journal of Cardiovascular Electrophysiology
- Publisher
- Wiley
- Published
- 2008-07
- Volume
- 19
- Issue
- 7
- Pages
- 668-672
- ISSN
- 1045-3873 (ISSN-L)
- 1540-8167
- OpenAlex
- W2169161075
- Semantic Scholar
- 4c80f7ae98979785ff6faf5df2439737c93dd4eb
- Cited by
- 219
- References
- 20
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 7 · 2023: 8 · 2022: 15 · 2021: 9 · 2020: 11 · 2019: 7 · 2018: 15 · 2017: 21 · 2016: 11 · 2015: 12 · 2014: 15 · 2013: 22 · 2012: 21
- FWCI
- 8.98
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Journal of Cardiovascular Electrophysiology (publishedVersion)
- PubMed (publishedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- 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 › Physiology › Obstructive Sleep Apnea Research
- Keywords
- atrial fibrillation, obstructive sleep apnea, obesity, body mass index, radiofrequency catheter ablation, atrial fibrillation recurrence, complex fractionated atrial electrograms, left atrial size, ablation outcomes
- MeSH terms
- Atrial Fibrillation, Female, Humans, Male, Michigan, Middle Aged, Obesity, Risk Factors, Comorbidity, Body Mass Index, Prevalence, Treatment Outcome, Catheter Ablation, Risk Assessment, Sleep Apnea, Obstructive
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