Abstract 12357: Prevalence and Impact of Obesity Status in Current Randomized Controlled Trials of Catheter Ablation for Treatment of Atrial Fibrillation: A Systematic Review

Abstract

Introduction: The prevalence of obesity among patients with AF and its impact on catheter ablation outcomes remain controversial. We aimed to examine the proportion of obese participants enrolled in current AF ablation RCTs and outcomes of ablation among patients with obesity. Methods: We systematically searched PUBMED for RCTs examining catheter ablation for treatment of AF published between 01/2019 to 03/2022. When mean and standard deviation (SD) were available, normal distribution was assumed and a z-score was used to estimate the proportion of obese participants. A trial was classified as group A and B when conducted in countries where obesity is defined as BMI ≥30 and ≥25 kg/m 2 , respectively. Results: Of 26 RCTs comprising 1,582 participants, 19 (73.1%) trials reported the BMI of study participants, but only 2 (7.7%) specified the proportion of obesity (15.5% and 39.0%). Two trials excluded participants with BMI>35 kg/m 2 . In group A (N 1 =17), the mean BMI was 28.8±1.4 kg/m 2 with estimated obese participants of 39.7% (IQR 38-45 kg/m 2 ). The mean BMI in group B (N 2 =9) was 24.9±1.1 kg/m 2 with estimated obese participants of 47.1% (IQR 37-50 kg/m 2 ), Figure. Subgroup analysis examining the effect of catheter ablation according to the BMI status was not reported in any RCTs. Bivariate or multivariate analysis evaluating the effect of BMI or body weight were used in only 4 (15.4%) RCTs. The results suggested that BMI or body weight did not affect their main findings with risk ratio of 0.97-1.00. Conclusion: Current AF ablation RCTs underreport the actual proportion of participants with obesity. However, using the available mean BMI of the study subjects, concomitant obesity among AF patients was highly prevalent and identified in 40-50%. The impact of obesity on the main findings is not fully reported; thus, efficacy of AF ablation among obese patients could not be concluded.