Abstract 12362: Long-term Influence of Body Mass Index on Cardiovascular Events After Atrial Fibrillation Ablation

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Introduction: Catheter ablation of atrial fibrillation (AF) is an established therapeutic rhythm approach in symptomatic patients. Obesity is a dominant driver of AF recurrence after ablation. However it is not known what weight status will lower AF risk and also minimize long-term cardiac events. Hypothesis: An increased body mass index (BMI) will negatively impact cardiovascular outcomes after AF ablation. Methods: All patients that underwent an index ablation with a BMI recorded and at least 3 years of follow-up were included (n=1558). The group was separated and compared by index ablation BMI status (≤20, 21-25, 26-30, >30 kg/m 2 ). Long-term outcomes included AF recurrence, stroke/TIA, heart failure (HF) hospitalization, and death. Results: Patients increasing BMI strata were more likely to be male and have hypertension, a smoking history, diabetes, HF and a prior cardioversion. Patients with a BMI≤20 were more likely to have a moderate-high CHADS2 score. At 3 years, recurrence rates of AF increased significantly with increasing BMI status (p=0.02), but stroke rates were similar (p=0.06). Long-term death rates tended to increase inversely with BMI status and HF rates were greatest in the highest and lowest BMI groups (Figure). Conclusion: Lower weight at AF ablation, lowers arrhythmia recurrence risk. However, AF ablation patients that are underweight remain at high risk of other cardiovascular outcomes and the lower arrhythmia outcomes do not result in an observable stroke risk reduction.